Jessie Poveromo PSYD

NPI 1619294188 - Psychologist - 103TB0200X

NPI Details
NPI 1619294188
Gender Female
Enumeration Date 04/23/2010
Last Updated 07/06/2015
Entity Type Individual
Active Over 6 years ago
Practice Location
400 MONTAUK HWY 112
WEST ISLIP NY, 11795-4429, US
Phone (631) 321-7107
Fax
Business Location
400 MONTAUK HWY 112
WEST ISLIP NY, 11795-4429, US
Phone (631) 321-7107
Fax (631) 321-7108
Toxanomy
Taxonomy Code 103TB0200X
License State New York
License Number 018490
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According to our database, Dr. Jessie Poveromo PSYD NPI is 1619294188, taxonomy code is 103TB0200X and license number is 018490, license state is located at New York. Jessie Poveromo PSYD physically located at 400 Montauk Hwy 112, West Islip NY, 11795-4429. NPI Number Jessie Poveromo PSYD has the Individual type.

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1619294188 NPI number is provided on an as is basis without warranty of any kind. 1619294188 is maintained by the National Plan & Provider Enumeration System. The contents of Jessie Poveromo PSYD are for informational purposes only.