Individual
PAULA A IACOBAZZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
75 N COUNTRY RD, PORT JEFFERSON, NY 11777-2119
(631) 473-1320
Mailing address
9 MIDLAND AVE, ROCKY POINT, NY 11778-8779
(917) 886-6790
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
406122
NY
Other
Enumeration date
08/09/2024
Last updated
08/09/2024
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