TIJUANA TEMPLE

CORAM, NY
NPI1881369486
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: NY  348067)
Enumeration Date2021-08-16
Last Update Date2021-08-16
Business Address
TIJUANA TEMPLE FNP
65 PENNAQUID RD
CORAM, NY 11727-1227
Phone number: 631-605-1783
Mailing Address
TIJUANA TEMPLE FNP
65 PENNAQUID RD
CORAM, NY 11727-1227
Phone number: 631-605-1783