Individual
CRYSTAL KIMBERLY SANTOSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13620 38TH AVE STE 7D, FLUSHING, NY 11354-4232
(718) 539-2506
Mailing address
420 W 42ND ST APT 19D, NEW YORK, NY 10036-6846
(646) 266-3107
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
020151
NY
Other
Enumeration date
10/05/2016
Last updated
10/05/2016
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