Individual
MR. MARCO ANTONIO BERRONES JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
888 OLD COUNTRY RD, PLAINVIEW, NY 11803-4914
(516) 719-3000
Mailing address
972 BRUSH HOLLOW RD, WESTBURY, NY 11590-1740
(516) 876-5555
(516) 876-1246
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
008261-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00246075
—
NY
Enumeration date
10/16/2006
Last updated
06/25/2009
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