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1528022381
THERESA A PROVETTO
HUNTINGTON STATION, NY
NPI
1528022381
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: NY 002407)
Enumeration Date
2006-04-17
Last Update Date
2022-03-28
Business Address
THERESA A PROVETTO PA
180 E PULASKI RD
HUNTINGTON STATION, NY 11746-1915
Phone number: 631-425-2145
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Mailing Address
THERESA A PROVETTO PA
180 E PULASKI RD
HUNTINGTON STATION, NY 11746-1915
Phone number: 631-425-2145
Copy
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