Individual
CATHY WIRTENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
28 WAINWRIGHT ST, RONKONKOMA, NY 11779-4713
(631) 494-9768
Mailing address
28 WAINWRIGHT ST, RONKONKOMA, NY 11779-4713
(631) 494-9768
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
352222-1
NY
Other
Enumeration date
09/06/2016
Last updated
09/06/2016
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