Individual
BASIYMAH ESTEFANIA GOVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6800 JERICHO TPKE STE 120W, SYOSSET, NY 11791
(917) 993-0282
Mailing address
6800 JERICHO TPKE STE 120W, SYOSSET, NY 11791-4445
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
NY
Other
Enumeration date
09/19/2019
Last updated
09/19/2019
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