Individual
BETH ANN CHRILS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2147 SYCAMORE AVE, RONKONKOMA, NY 11779-6551
(631) 241-0751
Mailing address
2147 SYCAMORE AVE, RONKONKOMA, NY 11779-6551
(631) 241-0751
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2119791
NY
Other
Enumeration date
06/12/2012
Last updated
06/12/2012
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