Individual
LARA GATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTIONER
Contact information
Practice address
50 SANITORIUM RD, BLDG F - ROOM 240, POMONA, NY 10970-3555
(845) 364-2275
Mailing address
PO BOX 446, STONY POINT, NY 10980-0446
(845) 627-1268
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
F400961
NY
Other
Enumeration date
06/01/2007
Last updated
07/08/2007
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