Individual
LORETO VERGARA TANAEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3245 NOSTRAND AVE, KINGS HWY CENTER, BROOKLYN, NY 11229
(718) 615-3777
(718) 615-3481
Mailing address
233 NOSTRAND AVE, ATTENTION CELESTE JACKSON, BROOKLYN, NY 11205
(718) 826-3911
(718) 826-3860
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
1138351
NY
Other
Enumeration date
10/03/2006
Last updated
07/08/2007
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