Individual
MARYANN DELUCA-GREENLAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
191 FAIRVIEW AVE, BAYPORT, NY 11705-1873
(631) 563-4956
Mailing address
191 FAIRVIEW AVE, BAYPORT, NY 11705-1873
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
668418121
NY
Other
Enumeration date
09/11/2016
Last updated
09/11/2016
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