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Organization
LASER BREAST STANDARD CANCER SURGERY
Active
Organization
LASER BREAST STANDARD CANCER SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VINCENT ANSANELLI JR. (DIRECTOR)
(516) 938-4686
Entity
Organization
Contact information
Practice address
100 MANETTO HILL RD, SUITE 210, PLAINVIEW, NY 11803
(516) 938-4686
Mailing address
27 W 60TH ST, P.O BOX 20760, NEW YORK, NY 10023-9991
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
07/20/2012
Last updated
07/20/2012
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