Individual
EMMA FEDORYK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
49 NESCONSET HWY, PORT JEFFERSON STATION, NY 11776-2628
(631) 751-3000
Mailing address
1 RESEARCH RD, RIDGE, NY 11961-2701
(631) 751-3000
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
363A00000X
Physician Assistant
Primary
033644-01
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/18/2018
Last updated
04/07/2026
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