Individual
MS. MICHELE HOLLY CACCAVANO
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
3001 EXPRESSWAY DR N, SUITE A, ISLANDIA, NY 11749-5301
(631) 444-6491
(631) 444-9623
Mailing address
61 EIMER ST, PATCHOGUE, NY 11772-1169
(631) 444-6491
(631) 444-9623
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F302258-1
NY
Other
Enumeration date
09/08/2005
Last updated
07/08/2007
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