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Luis Angel Riquelme III
Medical Physician Assistant in Stony Brook, New York
NPI 1871933515

Luis Angel Riquelme III is a Medical Physician Assistant based in West Islip, NY and is specialized in Medical. Luis Angel Riquelme III practices in Stony Brook, NY. The NPI Number for Luis Angel Riquelme III is 1871933515 and holds a License No. 016630 (New York).

The current practice location address for Luis Angel Riquelme III is 101 Nicolls Rd, Stony Brook, NY and can be reached out via phone at 631-358-1201 and via fax at 631-444-8850.

Location: 101 Nicolls Rd, Stony Brook, NY, 11795-2620
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1871933515
Provider Name
Luis Angel Riquelme III
Credential
Provider Entity Type
Individual
Gender
Male
Address
101 Nicolls Rd, Stony Brook, NY, 11795-2620
Phone Number
631-358-1201
Fax Number
631-444-8850
Provider Enumeration Date
06/26/2013
Last Update Date
05/18/2024
institution
Provider Business Practice Location Address Details
Address
101 Nicolls Rd
City
Stony Brook
State
New York
Zip
11794-3208
Phone Number
631-358-1201
Fax Number
631-444-8850
person
Provider Business Mailing Address Details
Address
101 Nicolls Rd
City
Stony Brook
State
New York
Zip
11794-3208
Phone Number
631-358-1201
Fax Number
631-444-8850
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
363AM0700X
License No.
016630 (New York)
Definition
Definition to come...
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