Michelle Mary Depta

NPI #1598230914 in Oyster Bay, New York

Provider Information

NPI Number: 1598230914
Entity Type: Individual
Name: Michelle Mary Depta
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Specialist
Enumeration Date: Oct 11, 2018
Last Updated: Oct 11, 2018

Practice Location

Address: 127 SOUTH ST APT 3D
City: Oyster Bay
State: New York
ZIP Code: 11771-2272
Phone: (516) 754-6609

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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