JUSTINE DELISE
Medical Practice at Coventry Ln, Smithtown, NY

License number
New York 008506-1
Category
Medical Practice
Type
Specialist
Address
Address
8 Coventry Ln, Smithtown, NY 11787
Phone
(631) 834-0663
National Provider ID: 1467858084
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Personal information

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Name
Address
Phone
Justine Delise
8 Coventry Ln, Smithtown, NY 11787

Organization information

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JUSTINE DELISE OT PC

8 Coventry Ln, Smithtown, NY 11787

Registration:
Sep 9, 2014
State ID:
4633570
Business type:
DOMESTIC PROFESSIONAL CORPORATION

Medical Practice licenses in New York