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Individual

KIMBERLY V GO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ANP

Contact information

Practice address
100 PORT WASHINGTON BLVD, ROSLYN, NY 11576-1353
(516) 629-2467
(516) 629-2027
Mailing address
PO BOX 1061, PORT WASHINGTON, NY 11050-1061
(516) 629-2467
(516) 629-2027

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F304120
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02734467
NY
Enumeration date
08/13/2006
Last updated
11/14/2008
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