Organization
JOSEPH REALE PHYSICIAN ASSISTANT PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH REALE PA (OWNER)
(516) 532-7805
Entity
Organization
Contact information
Practice address
12 ALFRED LN, KINGS PARK, NY 11754-5013
(516) 532-7805
(973) 291-4439
Mailing address
12 ALFRED LN, KINGS PARK, NY 11754-5013
(516) 532-7805
(973) 291-4439
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
004677
NY
Other
Enumeration date
07/15/2009
Last updated
07/15/2009
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