SUPRANEE PROMBANTHOA

EAST MEADOW, NY
NPI1942442223
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: NY  012965)
Enumeration Date2009-04-01
Last Update Date2009-04-01
Business Address
-- SUPRANEE PROMBANTHOA PA
2201 HEMPSTEAD TPKE
EAST MEADOW, NY 11554-1859
Phone number: 516-572-6501
Mailing Address
-- SUPRANEE PROMBANTHOA PA
2201 HEMPSTEAD TPKE
EAST MEADOW, NY 11554-1859
Phone number: 516-572-6501
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