Individual
ALLAN D MEMORACION
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
280 E MAIN ST, BAY SHORE, NY 11706-8403
(631) 591-7400
Mailing address
280 E MAIN ST, BAY SHORE, NY 11706-8403
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
307954
NY
Other
Enumeration date
08/24/2016
Last updated
08/24/2016
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