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1740754514
TREVOR MARK AMBRICO
BAY SHORE, NY
NPI
1740754514
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2019-01-15
Last Update Date
2019-01-15
Business Address
TREVOR MARK AMBRICO
301 E MAIN ST
BAY SHORE, NY 11706-8408
Phone number: 631-968-3000
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Mailing Address
TREVOR MARK AMBRICO
115 SMITH ST
LYNBROOK, NY 11563-1527
Phone number: 516-204-2774
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