Individual
MR. JOHN O GAETANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
259 1ST ST, MINEOLA, NY 11501-3957
(516) 663-8948
Mailing address
386 SOUTHPORT ST, RONKONKOMA, NY 11779-6265
(631) 981-6353
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
001377
NY
Other
Enumeration date
10/14/2008
Last updated
10/14/2008
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