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Organization
GLEN COVE FACULTY MEDICAL AFFILIATES, UNIVERSITY FACULTY PRACTICE CORP
Active
Organization
GLEN COVE FACULTY MEDICAL AFFILIATES, UNIVERSITY FACULTY PRACTICE CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY PRINZIVALLI PA (ADMINISTRATOR)
(516) 674-7300
Entity
Organization
Contact information
Practice address
101 SAINT ANDREWS LN, GLEN COVE, NY 11542-2254
(516) 674-7300
(516) 674-7588
Mailing address
101 SAINT ANDREWS LN, GLEN COVE, NY 11542-2254
(516) 674-7300
(516) 674-7588
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
07/08/2024
Last updated
07/08/2024
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