Individual
BRIANNA ANN DEVINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
51 FOREST AVE, NESCONSET, NY 11767-3251
(631) 449-2152
Mailing address
51 FOREST AVE, NESCONSET, NY 11767-3251
(631) 449-2152
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
3103362
NY
Other
Enumeration date
05/05/2023
Last updated
05/05/2023
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