Individual
ANTHONY ALLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
134 PATCHOGUE AVE, MASTIC, NY 11950-3607
(631) 926-6906
Mailing address
134 PATCHOGUE AVE, MASTIC, NY 11950-3607
(631) 926-6906
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
3270721
NY
Other
Enumeration date
01/18/2017
Last updated
01/18/2017
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