Individual
COREY DALLAS PREZZANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
301 E MAIN ST, BAY SHORE, NY 11706-8408
(631) 968-3000
Mailing address
325 LAKE AVE UNIT 2159, SAINT JAMES, NY 11780-5030
(631) 487-7986
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
030721
NY
Other
Enumeration date
10/03/2023
Last updated
10/18/2023
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