Individual
CID SQUIRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
275 NORTH ST, HARRISON, NY 10528-1524
(914) 925-5211
Mailing address
275 NORTH STREET, HARRISON, NY 10528
(914) 925-5211
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
489752
NY
Other
Enumeration date
04/07/2009
Last updated
04/07/2009
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