Organization
EM-SAPA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE VENTURA PA (PA)
(631) 944-2788
Entity
Organization
Contact information
Practice address
19 CLAYTON DR, DIX HILLS, NY 11746-5503
(631) 944-2788
Mailing address
19 CLAYTON DR, DIX HILLS, NY 11746-5503
(631) 944-2788
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
NY
Other
Enumeration date
05/08/2008
Last updated
07/21/2022
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