Individual
MS. FIZZAH IDREES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1279 E MAIN ST, RIVERHEAD, NY 11901-2583
(631) 727-2100
Mailing address
1279 E MAIN ST, RIVERHEAD, NY 11901-2583
(631) 727-2100
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
017477
NY
Other
Enumeration date
04/07/2014
Last updated
12/03/2024
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