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Individual
JOSEPH REALE
Active
Individual
JOSEPH REALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
004677
NY
363AS0400X
Surgical Physician Assistant
004677-1
NY
Other
Enumeration date
11/02/2005
Last updated
09/08/2009
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