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1700224367
STEPHANIE YVETTE STORE
ROSEDALE, NY
NPI
1700224367
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: NY F336569-1)
Enumeration Date
2013-06-05
Last Update Date
2013-06-05
Business Address
-- STEPHANIE YVETTE STORE FNP
245-11 134 AVE
ROSEDALE, NY 11422
Phone number: 646-309-4034
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Mailing Address
-- STEPHANIE YVETTE STORE FNP
24511 134TH AVE
ROSEDALE, NY 11422-1426
Phone number: 646-309-4034
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