Individual
DR. ASSUNTA DIVALENTINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
45 ROUTE 25A, SHOREHAM, NY 11786-1389
(631) 744-3303
Mailing address
PO BOX 1559, STONY BROOK, NY 11790
(530) 219-6268
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
287066-1
NY
Other
Enumeration date
04/15/2013
Last updated
07/21/2022
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