Individual
ALEXA PANEBIANCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
291 MURIEL ST, HOLBROOK, NY 11741-3819
(631) 972-8687
Mailing address
291 MURIEL ST, HOLBROOK, NY 11741-3819
(631) 972-8687
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1707614231
NY
Other
Enumeration date
05/12/2023
Last updated
05/12/2023
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