Individual
ANGELA MARIE SELVAGGIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
B.A.E.D.
Contact information
Practice address
539 BAYPORT AVE, BAYPORT, NY 11705-1419
(631) 868-3040
Mailing address
539 BAYPORT AVE, BAYPORT, NY 11705-1419
(631) 868-3040
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1789450
NY
Other
Enumeration date
01/25/2007
Last updated
07/08/2007
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