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Get Application Cover Sheet - New York State Department Of Health - Health Ny

Under the New York "State 30" J-1 Visa waiver program for FFY 2014. Please complete and mail, along with all other requested materials, to: New York State Department of Health, Corning Tower Room 1695, Albany, New York 12237-0001 (phone: 518-473-7019). Please print clearly or type. I. IDENTIFYING INFORMATION - PHYSICIAN NAME: Last First Middle Initial ADDRESS:.

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