Individual
ALICIA DETOMASO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
220 VETERANS HWY, HAUPPAUGE, NY 11788-2420
(516) 736-1588
Mailing address
4 LARAMIE CT, CORAM, NY 11727-1514
(631) 521-3483
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
797314
NY
Other
Enumeration date
10/02/2016
Last updated
08/23/2024
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