Individual
MRS. SHANNAN MARIE MAXEY-RICOY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RPA-C
Contact information
Practice address
221 BROADWAY, SUITE 207, AMITYVILLE, NY 11701-2780
(631) 598-0009
(631) 598-0099
Mailing address
99 KENTUCKY ST, LONG BEACH, NY 11561-1229
(516) 902-8389
(516) 897-6458
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
009533
NY
Other
Enumeration date
06/11/2006
Last updated
07/08/2007
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