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Individual

DR. BERNADETTE PAVLIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
N.P.

Contact information

Practice address
205 N BELLE MEAD AVE, EAST SETAUKET, NY 11733
(631) 444-4630
Mailing address
P.O. BOX 1559, STONY BROOK, NY 11790
(631) 444-4630

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F301377
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02127737
NY
01
0E2511
EMPIRE BC.BS
NY
Enumeration date
07/12/2006
Last updated
07/08/2007
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