Most Relevant Information
Provider Data
| NPI Number: | 1003225194 |
| Provider Name: | MICHELLE STEWART PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363AS0400X |
| Specialty: | Physician Assistant |
| License Number: | 017815 |
Most Important Dates
| Enumeration Date: | 08/04/2014 |
| Last Updated: | 08/04/2014 |
Provider Practice Location
600 NORTHERN BLVD
SUITE 300
GREAT NECK
NY
110215206
Practice Location Phone/Fax
| Phone: | 5166278717 |
| Fax: |
Provider Mailing Location
1456 31ST DR
APT 4H
ASTORIA
NY
111064569
Provider Mailing Phone/Fax
| Phone: | 6318979922 |
| Fax: |