Individual
ANTHONY JAMES TISI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
761 MERRICK AVE, WESTBURY, NY 11590-6608
(516) 357-8777
Mailing address
761 MERRICK AVE, WESTBURY, NY 11590-6608
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
017339
NY
Other
Enumeration date
03/28/2014
Last updated
11/07/2017
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