Individual
MS. ANGELA R TASSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
74 MILL DR, MASTIC BEACH, NY 11951-1403
(631) 657-6038
Mailing address
80 MARILYNN ST, EAST ISLIP, NY 11730-2705
(631) 581-0465
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
306789-1
NY
Other
Enumeration date
10/11/2011
Last updated
10/11/2011
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