Individual
JENNA DAVINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4160 MERRICK RD STE 3, MASSAPEQUA, NY 11758-6027
(516) 590-7410
Mailing address
105 DORIS PL, MASSAPEQUA, NY 11758-4004
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
06/24/2016
Last updated
02/09/2023
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