CLAUDIA MIKE PROVENZALE

STONY BROOK, NY
NPI1245009547
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy207R00000X Internal Medicine
(Licence: NY  F310912-01)
Enumeration Date2023-12-28
Last Update Date2024-03-11
Business Address
Mrs. CLAUDIA MIKE PROVENZALE AGNP
2500 NESCONSET HWY BLDG 11D
STONY BROOK, NY 11790-2553
Phone number: 631-689-7899
Mailing Address
Mrs. CLAUDIA MIKE PROVENZALE AGNP
2500 NESCONSET HWY
STONY BROOK, NY 11790-2555
Phone number: 631-689-7899
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