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Individual provider · Military Health Care Provider · Staten Island, NY

NPI
1871635664
Type
Individual (Type 1)
Primary specialty
Military Health Care Provider
Specialty group
Other Service Providers
Taxonomy code
171000000X
Sex
Male
Sole proprietor
No
Enumerated
2007-02-12
Last updated
2007-07-08
Practice location
215 Drum Rd
Staten Island, NY 10305-5001
(718) 354-4414

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