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KIM STAPLES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RPA-C

Contact information

Practice address
554 LARKFIELD RD, STE 101, EAST NORTHPORT, NY 11731-4205
(631) 386-9166
Mailing address
554 LARKFIELD RD, STE 101, EAST NORTHPORT, NY 11731-4205
(631) 368-9166

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
017142
NY

Other

Enumeration date
11/01/2013
Last updated
05/31/2016
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