Individual
IRENE DIANA PATRYLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
200 BELLE TERRE RD, PORT JEFFERSON, NY 11777-1928
(631) 474-6879
(631) 474-6448
Mailing address
200 BELLE TERRE RD, PORT JEFFERSON, NY 11777-1928
(631) 474-6879
(631) 474-6448
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
198926
NY
Other
Enumeration date
05/06/2008
Last updated
06/26/2009
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