Individual
MRS. CLAUDIA MIKE PROVENZALE
Active
Individual
MRS. CLAUDIA MIKE PROVENZALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGNP
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
F310912-01
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
310912
NY
Other
Enumeration date
12/28/2023
Last updated
01/16/2026
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