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Individual

ROBERT REDICAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
300 COMMUNITY DR, MANHASSET, NY 11030-3816
(516) 562-4017
Mailing address
972 BRUSH HOLLOW RD, WESTBURY, NY 11590-1740
(516) 876-5555
(516) 876-1246

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
006195
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01893796
NY
Enumeration date
03/29/2007
Last updated
07/08/2007
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