Individual
MR. VALSAN OOMMEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPA-C
Contact information
Practice address
100 NICOLLS RD, STONY BROOK, NY 11794-0001
(631) 601-4387
Mailing address
26 JORDAN DR, MEDFORD, NY 11763-2051
(917) 609-8200
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
012214
NY
Other
Enumeration date
01/10/2008
Last updated
01/13/2021
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