Individual
FARHAT JOHN SAMUELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
86 PATCHOGUE AVE, MASTIC, NY 11950-3605
(631) 394-7511
Mailing address
86 PATCHOGUE AVE, MASTIC, NY 11950-3605
(631) 394-7511
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
677803-1
NY
Other
Enumeration date
07/25/2018
Last updated
07/25/2018
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