REGGIE DONALD VALDEMAR

RONKONKOMA, NY
NPI1285374660
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: NY  404034)
Enumeration Date2022-03-31
Last Update Date2022-12-26
Business Address
REGGIE DONALD VALDEMAR phmnp
153 LAKE SHORE RD
RONKONKOMA, NY 11779-3157
Phone number: 111-111-1111
Mailing Address
REGGIE DONALD VALDEMAR phmnp
7 OAK PARK CT
DEER PARK, NY 11729-5607
Phone number: 631-565-3480