Individual
HOLLY VESCOVI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
370 ROCKY POINT RD, EAST MARION, NY 11939-1123
(631) 477-5912
Mailing address
PO BOX 204, EAST MARION, NY 11939-0204
(631) 477-5912
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
38629
NY
Other
Enumeration date
04/10/2016
Last updated
04/10/2016
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