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Rupert E Evans III, PA

Physician Assistant, Surgical in New Hyde Park, NY. Individual provider (NPI-1).

NPI number1346359981
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1346359981
Entity type
Individual (NPI-1)
Name
Rupert E Evans III
Credential
PA
Sex
Male
Sole proprietor
Yes
Enumeration date
Aug 29, 2006
Last updated
Jul 8, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363AS0400X Physician Assistant, Surgical010204NYYes

Practice location

27005 76th Ave
New Hyde Park, NY 11040-1433

Phone 718-470-7211

Mailing address

175 Community Dr
Great Neck, NY 11021-5502

Phone 516-465-1900 · Fax 516-465-1830

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