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MR. LESEGO A GOBA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
N.P

Contact information

Practice address
7 GLOUCESTER DR, WHEATLEY HEIGHTS, NY 11798-1207
(718) 307-1577
Mailing address
7 GLOUCESTER DR, WHEATLEY HEIGHTS, NY 11798-1207
(718) 307-1577

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
40402072
NY

Other

Enumeration date
08/08/2016
Last updated
11/20/2022
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