is a Specialist in Hewlett, New York. practices all healthcare services and medical treatments related to Specialist. The NPI Number for is 1821109752. The last update date is .
's current location address is 1057 Channel Dr, Hewlett, New York. You can contact this provider via phone number 9178371268 and fax number 7187149346. The mailing address for is 1057 Channel Dr, Hewlett, New York. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 1057 Channel Dr, Hewlett, New York |
| Phone Number | 9178371268 |
| Fax Number | 7187149346 |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1821109752 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 1057 Channel Dr |
|---|---|
| City | Hewlett |
| State | New York (NY) |
| Post Code | 115572616 |
| Phone Number | 9178371268 |
| Fax Number | 7187149346 |
Provider's Primary Taxonomy Detail
| Speciality | Specialist |
|---|---|
| Taxonomy | 174400000X |
| Licence No | 20674 |
|
Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 2216439 | NY | -- |
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