Individual
JOSEPH REALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1 HEALTHY WAY, ATTN: PHYSICIAN BILLING DEPT, OCEANSIDE, NY 11572-1551
(516) 632-3000
Mailing address
12 ALFRED LANE, KINGS PARK, NY 11754
(516) 632-3000
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
004677
NY
363AS0400X
Surgical Physician Assistant
004677-1
NY
Other
Enumeration date
11/02/2005
Last updated
09/08/2009
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