Individual
STEPHANIE VIRASAWMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A, ATR-BC,LCAT
Contact information
Practice address
4419 3RD AVE, BRONX, NY 10457-2562
(718) 364-7700
(718) 364-1513
Mailing address
34 FIG ST, CENTRAL ISLIP, NY 11722-4002
Taxonomy
Speciality
Code
Description
License number
State
246ZA2600X
Medical Art Specialist/Technologist
Primary
002036
NY
Other
Enumeration date
11/06/2017
Last updated
12/11/2017
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