Individual
ANITA DIGIACOMO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4 WELLWOOD DR, SHIRLEY, NY 11967-3721
(631) 399-1009
Mailing address
4 WELLWOOD DR, SHIRLEY, NY 11967-3721
(631) 399-1009
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
434267-1
NY
Other
Enumeration date
08/02/2014
Last updated
08/02/2014
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