Individual
STEPHANIE PHILOMENA BURNS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
75 N COUNTRY RD, PORT JEFFERSON, NY 11777-2119
(631) 839-2459
Mailing address
76 HEDGES AVE, EAST PATCHOGUE, NY 11772-5503
(631) 839-2459
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
020587-1
NY
Other
Enumeration date
01/31/2017
Last updated
08/12/2020
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