Individual
LYNETTE GRECIA PEGUERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 920-4321
Mailing address
1051 WHEELER AVE PH, BRONX, NY 10472-5509
(347) 285-3138
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
23019691
NY
Other
Enumeration date
06/01/2016
Last updated
06/01/2016
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