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1629533112
LEIGHANN AQUAVIVA
MEDFORD, NY
NPI
1629533112
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2019-02-08
Last Update Date
2019-02-08
Business Address
LEIGHANN AQUAVIVA
12 PLATINUM CT
MEDFORD, NY 11763-2247
Phone number: 631-868-3577
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Mailing Address
LEIGHANN AQUAVIVA
235 BLUE POINT AVE
BLUE POINT, NY 11715-1261
Phone number: 631-363-5794
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