Individual
KATIE FARGNOLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
883 STANLEY ST, WEST ISLIP, NY 11795-2610
(516) 344-0165
Mailing address
883 STANLEY ST, WEST ISLIP, NY 11795-2610
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
221721
NY
Other
Enumeration date
07/18/2018
Last updated
06/28/2023
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