Individual
GABRIELLA YEGANEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9 BROOK LN, GLEN HEAD, NY 11545-3100
(516) 592-9639
Mailing address
9 BROOK LN, GLEN HEAD, NY 11545-3100
(516) 592-9639
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
026624
NY
Other
Enumeration date
02/21/2022
Last updated
02/21/2022
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