Individual
MICHELLE LYNN VIOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
48 SWAN LN, BRENTWOOD, NY 11717-6804
(631) 434-2467
Mailing address
936 MAPLE ST, BOHEMIA, NY 11716-4206
(631) 484-1301
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
667745
NY
Other
Enumeration date
10/22/2018
Last updated
10/22/2018
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