Most Relevant Information
Provider Data
| NPI Number: | 1003034141 |
| Provider Name: | KRISTY SELVAGGI RPAC |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | 010787 |
Most Important Dates
| Enumeration Date: | 04/23/2007 |
| Last Updated: | 10/17/2014 |
Provider Practice Location
1000 MONTAUK HIGHWAY
GOOD SAMARITAN HOSPITAL
WEST ISLIP
NY
11795
Practice Location Phone/Fax
| Phone: | 6313764444 |
| Fax: |
Provider Mailing Location
23 ACORN LANE
STONY BROOK
NY
11790
Provider Mailing Phone/Fax
| Phone: | 6318072568 |
| Fax: |