Individual
MR. CARMELO CENTENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
259 DELAWARE AVE, BAY SHORE, NY 11706
(631) 338-8489
Mailing address
259 DELAWARE AVE, BAY SHORE, NY 11706-3317
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
735825
NY
Other
Enumeration date
07/16/2013
Last updated
08/11/2018
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