Individual
JESSICA L DEVITO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11 ELSTON CT, LAKE GROVE, NY 11755-2800
(631) 702-0299
Mailing address
11 ELSTON CT, LAKE GROVE, NY 11755-2800
(631) 702-0299
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
1189762
NY
253Z00000X
In Home Supportive Care Agency
Primary
1189762
NY
Other
Enumeration date
04/20/2017
Last updated
02/14/2022
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