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1801675400
EDWARD FONSECA
ELMHURST, NY
NPI
1801675400
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LA2200X Nurse Practitioner, Adult Health
(Licence: NY 311410)
Enumeration Date
2023-09-25
Last Update Date
2024-07-12
Business Address
EDWARD FONSECA
4010 FORLEY ST
ELMHURST, NY 11373-1427
Phone number: 718-565-6565
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Mailing Address
EDWARD FONSECA
4010 FORLEY ST
ELMHURST, NY 11373-1427
Phone number: 718-565-6565
Copy
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