Individual
MR. ANGELO THOMAS MINERVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
79 MIDDLEVILLE RD, NORTHPORT, NY 11768-2200
(631) 261-4400
Mailing address
3509 CENTERVIEW AVE, WANTAGH, NY 11793-2709
(516) 785-2302
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
32231
NY
Other
Enumeration date
09/15/2006
Last updated
09/07/2023
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