LUIS ANGEL RIQUELME

STONY BROOK, NY
NPI1871933515
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363AM0700X Physician Assistant Medical
(Licence: NY  016630)
Enumeration Date2013-06-26
Last Update Date2024-05-09
Business Address
LUIS ANGEL RIQUELME
101 NICOLLS RD
STONY BROOK, NY 11794-3208
Phone number: 631-358-1201
Mailing Address
LUIS ANGEL RIQUELME
16 WESTMINSTER LN
WEST ISLIP, NY 11795-2620
Phone number: 631-747-2526
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