Individual
DYANE LYN CAVAGNARO-IRVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
475 SEAVIEW AVE, STATEN ISLAND, NY 10305-3436
(718) 226-9360
Mailing address
216 BRYANT AVE, STATEN ISLAND, NY 10306-3104
(718) 351-8287
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
005387-1
NY
Other
Enumeration date
12/23/2016
Last updated
12/23/2016
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