is a Physician Assistant in Staten Island, New York. practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for is 1225247612. The last update date is .
's current location address is 1150 Forest Hill Rd Bldg 12b, Staten Island, New York. You can contact this provider via phone number 7189835289. The mailing address for is 1150 Forest Hill Rd Bldg 12b, Staten Island, New York. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 1150 Forest Hill Rd Bldg 12b, Staten Island, New York |
| Phone Number | 7189835289 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1225247612 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 1150 Forest Hill Rd Bldg 12b |
|---|---|
| City | Staten Island |
| State | New York (NY) |
| Post Code | 103146316 |
| Phone Number | 7189835289 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | 7005 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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