Individual
ALLISON MARIE PROVENZALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
300 COMMUNITY DR, MANHASSET, NY 11030-3816
(516) 562-0100
Mailing address
6 WICHITA PATH, OAKLAND, NJ 07436-3818
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
431178
NY
Other
Enumeration date
08/24/2017
Last updated
08/24/2017
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