Individual
MISS CHRISTINA DICOSIMO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
301 E MAIN ST, BAY SHORE, NY 11706-8408
(631) 968-3000
Mailing address
33 ABRAMS PL, LYNBROOK, NY 11563-4235
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/10/2021
Last updated
09/12/2022
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