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1528310216
ASTRID THALIA JEAN
BRONX, NY
NPI
1528310216
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Former Name
ASTRID THALIA LOUIS
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
(Licence: NY 015363)
Enumeration Date
2012-10-05
Last Update Date
2018-11-08
Business Address
Mrs. ASTRID THALIA JEAN PA
111 E 210TH ST
BRONX, NY 10467-2401
Phone number: 718-920-4321
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Mailing Address
Mrs. ASTRID THALIA JEAN PA
3411 WAYNE AVE APT 8L
BRONX, NY 10467-2509
Phone number: 347-879-5978
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