Individual
MS. PHYLLIS VRETENICIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
527 PEARL ST, OCEANSIDE, NY 11572-1934
(516) 581-0960
Mailing address
527 PEARL ST, OCEANSIDE, NY 11572-1934
(516) 581-0960
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
387820031
NY
Other
Enumeration date
08/12/2014
Last updated
08/12/2014
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