Individual
MR. STANLEY FERTILIEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RT
Contact information
Practice address
25 ROBERT PITT DR STE 109, MONSEY, NY 10952-3366
(845) 625-2810
Mailing address
247 OAKLEY AVE, ELMONT, NY 11003-2533
(917) 600-0759
Taxonomy
Speciality
Code
Description
License number
State
2278G1100X
General Care Certified Respiratory Therapist
Primary
004526
NY
Other
Enumeration date
01/24/2012
Last updated
01/24/2012
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