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Individual

MR. ANSELL THEODORE HORN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
300 SKILLMAN AVE, LUTHERAN FHC -COMMUNITY MEDICINE, BROOKLYN, NY 11211-1607
(718) 302-7366
(718) 963-4016
Mailing address
300 SKILLMAN AVE, LUTHERAN FHC -COMMUNITY MEDICINE, BROOKLYN, NY 11211-1607
(718) 302-7366
(718) 963-4016

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F333304
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02744136
NY
Enumeration date
08/04/2006
Last updated
11/07/2014
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