Individual
GRISEL PAULINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
259 1ST ST, MINEOLA, NY 11501-3957
(631) 579-1776
Mailing address
259 1ST ST, MINEOLA, NY 11501-3957
(631) 579-1776
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
029380
NY
Other
Enumeration date
07/07/2023
Last updated
07/07/2023
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