Individual
MICHELLE STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
600 NORTHERN BLVD, SUITE 300, GREAT NECK, NY 11021-5206
(516) 627-8717
Mailing address
1456 31ST DR, APT 4H, ASTORIA, NY 11106-4569
(631) 897-9922
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
017815
NY
Other
Enumeration date
08/04/2014
Last updated
08/04/2014
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