The Provider Group

NPI #1063824738 in Astoria, New York

Provider Information

NPI Number
1063824738
Entity Type
Organization
Organization Name
The Provider Group
Primary Specialty
Nursing Care
Enumeration Date
May 28, 2014
Last Updated
May 28, 2014

Practice Location

Address
2717 CRESCENT ST
Address 2
SUITE 5A
ZIP Code
11102-2507
Phone
(718) 866-8008

Authorized Official

Name
MR. ANTHONY GAMBUZZA
Title
COO
Phone
(718) 866-8008

Specialties & Taxonomy Codes

Specialty
Nursing Care

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