Individual
MS. MICHELLE LEE ADAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A
Contact information
Practice address
601 SUFFOLK AVE, BRENTWOOD, NY 11717-4309
(631) 231-4455
(631) 257-5098
Mailing address
601 SUFFOLK AVE, BRENTWOOD, NY 11717-4309
(631) 231-4455
(631) 257-5098
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
012483
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P4752401
SUFFOLK HEALTH PLAN
—
Enumeration date
03/26/2008
Last updated
01/11/2017
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