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1881369486
TIJUANA TEMPLE
CORAM, NY
NPI
1881369486
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: NY 348067)
Enumeration Date
2021-08-16
Last Update Date
2021-08-16
Business Address
TIJUANA TEMPLE FNP
65 PENNAQUID RD
CORAM, NY 11727-1227
Phone number: 631-605-1783
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Mailing Address
TIJUANA TEMPLE FNP
65 PENNAQUID RD
CORAM, NY 11727-1227
Phone number: 631-605-1783
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