Individual
GINA SCANLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MPAS, PA-C
Contact information
Practice address
1600 DEER PARK AVE, SUITE G, DEER PARK, NY 11729-5208
(631) 667-0388
Mailing address
1231 DEER PARK AVE, NORTH BABYLON, NY 11703-3104
(631) 667-0388
(631) 968-7705
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
018262
NY
Other
Enumeration date
11/19/2014
Last updated
09/11/2024
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