Individual
CLAUDIO GINEBRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPA-C
Contact information
Practice address
96 RUSTIC AVE, MEDFORD, NY 11763-4448
(631) 495-4694
Mailing address
96 RUSTIC AVE, MEDFORD, NY 11763-4448
(631) 495-4694
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
015636
NY
Other
Enumeration date
06/15/2012
Last updated
06/15/2012
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