FREDERICK PATRICK KAVANAGH

BRENTWOOD, NY
NPI1346331154
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363A00000X Physician Assistant
(Licence: NY  006209-1)
Enumeration Date2006-09-27
Last Update Date2007-07-08
Business Address
-- FREDERICK PATRICK KAVANAGH RPA-C
1869 BRENTWOOD RD
BRENTWOOD, NY 11717-4625
Phone number: 631-853-3400
Mailing Address
-- FREDERICK PATRICK KAVANAGH RPA-C
2 GRAND ST
LAKE RONKONKOMA, NY 11779-1715
Phone number: 631-738-7417
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