Individual
ASHLEY DEJESUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
184 HANCOCK ST, BRENTWOOD, NY 11717-2827
(631) 691-9203
Mailing address
184 HANCOCK ST, BRENTWOOD, NY 11717-2827
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
08/30/2016
Last updated
08/30/2016
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