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Individual

MS. DIANE RANIERI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
PC 815 HALLOCK AVE., SUITE A KIDS FIRST PEDIATRICS,, PORT JEFFERSON STATION, NY 11776-1244
(631) 331-7267
(631) 331-7579
Mailing address
DEPT OF PA EDUC SCHOOL OF HLTH TECH AND MGMT, HSC L2 RM 425 STONY BROOK UNIVERSITY, STONY BROOK, NY 11794-0001
(631) 444-6132
(631) 444-1404

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
002743
NY

Other

Enumeration date
12/03/2008
Last updated
12/03/2008
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