Provetto, Theresa A

Provetto, Theresa A is an individual health care provider with primary practice located at 180 E Pulaski Rd , Huntington Station NY 11746-1915. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Provetto, Theresa A can be contacted via phone (631) 425-2145.

Contact Information

Primary practice address
180 E Pulaski Rd Huntington Station NY 11746-1915
Phone: (631) 425-2145
Fax: (631) 425-2296
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 002407 New York

Profile Details

NPI number 1528022381
LBN Legal business name Provetto, Theresa A
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 17th, 2006
Last updated Mar 28th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528022381 NPPES
New York MEDICAID 02066017

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