Individual
NICOLE PAIGE POLIMENI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4 KENWOOD ST, SETAUKET, NY 11733-2048
(631) 871-1412
Mailing address
4 KENWOOD ST, SETAUKET, NY 11733-2048
(631) 871-1412
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
019856
NY
Other
Enumeration date
07/12/2016
Last updated
07/12/2016
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