Most Relevant Information
Provider Data
| NPI Number: | 1003424318 |
| Provider Name: | HAE LIN SON |
| Entity Type: | Individual |
| Taxonomy Code: | 363LN0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 350501 |
Most Important Dates
| Enumeration Date: | 07/22/2020 |
| Last Updated: | 11/09/2020 |
Provider Practice Location
3959 BROADWAY
NEW YORK
NY
100321559
Practice Location Phone/Fax
| Phone: | 2016965960 |
| Fax: |
Provider Mailing Location
3959 BROADWAY
NEW YORK
NY
100321559
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |