Individual
ANTONETTA CASSIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
365 BROADWAY, AMITYVILLE, NY 11701-2716
(631) 608-8523
Mailing address
365 BROADWAY, AMITYVILLE, NY 11701-2716
(631) 608-8523
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
254459
NY
Other
Enumeration date
01/11/2017
Last updated
01/11/2017
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