Individual
AMY BETH GERVASIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
644 WADING RIVER HOLLOW RD, MIDDLE ISLAND, NY 11953-2136
(631) 365-9506
Mailing address
644 WADING RIVER HOLLOW RD, MIDDLE ISLAND, NY 11953-2136
(631) 365-9506
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
647669-1
NY
Other
Enumeration date
07/23/2019
Last updated
07/23/2019
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