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Individual

ABIGAIL L CANALETICH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
9 MIKE LN, SMITHTOWN, NY 11787-2326
(631) 561-5533
Mailing address
9 MIKE LN, SMITHTOWN, NY 11787-2326
(631) 561-5533

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
02791101
NY
363A00000X
Physician Assistant
390200000X
Student in an Organized Health Care Education/Training Program
NY

Other

Enumeration date
08/31/2021
Last updated
05/05/2022
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