Individual
MRS. MARY ELLEN ITZKOWITZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
159 BYRD ST, OCEANSIDE, NY 11572-5503
(516) 766-8923
(516) 766-8923
Mailing address
159 BYRD ST, OCEANSIDE, NY 11572-5503
(516) 766-8923
(516) 766-8923
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
05/19/2009
Last updated
05/19/2009
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