Individual
MR. LISA MARIE GAETA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
265 EASTWOOD AVE, DEER PARK, NY 11729-2203
(631) 243-5177
Mailing address
265 EASTWOOD AVE, DEER PARK, NY 11729-2203
(631) 243-5177
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
616269-1
NY
Other
Enumeration date
03/06/2010
Last updated
03/08/2010
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