Individual
MISS DIANNE GRACE ALCALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
100 W OAK ST, AMITYVILLE, NY 11701-2927
(631) 264-1800
Mailing address
100 W OAK ST, AMITYVILLE, NY 11701-2927
(631) 264-1800
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
310278
NY
Other
Enumeration date
07/10/2021
Last updated
07/10/2021
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