Individual
ALLISON MICHELE PEMBERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
25145 71ST AVE, BELLEROSE, NY 11426-2700
(631) 882-5424
Mailing address
25145 71ST AVE, BELLEROSE, NY 11426-2700
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1857521
NY
Other
Enumeration date
08/18/2013
Last updated
08/18/2013
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