Individual
ASHLEY DIANNE DEGROFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
14 BELLEMEADE AVE, SMITHTOWN, NY 11787
(631) 265-5300
Mailing address
121 BARRAUD DR, PORT JEFFERSON STATION, NY 11776-8007
(631) 561-9603
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
329095
NY
Other
Enumeration date
09/03/2017
Last updated
09/03/2017
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