Individual
DR. MOLAVE AGANA ADANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
510 MONTAUK HWY, SUITE C, WEST ISLIP, NY 11795-4422
(631) 587-1451
(631) 587-0503
Mailing address
510 MONTAUK HWY, SUITE C, WEST ISLIP, NY 11795
(631) 587-1451
(631) 587-0503
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
111104
NY
Other
Enumeration date
11/22/2005
Last updated
07/08/2007
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