Individual
MRS. DENISE LYNN PUWALSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
221 JERICHO TPKE, SYOSSET, NY 11791-4515
(516) 496-6400
Mailing address
15 GATEWAY LN, MANORVILLE, NY 11949-2528
(631) 878-2741
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
003270
NY
Other
Enumeration date
09/22/2010
Last updated
09/22/2010
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