Individual
DENISE MARIE ALBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
180 BROADWAY, HICKSVILLE, NY 11801-4230
(516) 935-6858
Mailing address
180 BROADWAY, HICKSVILLE, NY 11801-4230
(516) 935-6858
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113422018
—
NY
Enumeration date
03/12/2019
Last updated
03/12/2019
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