Provider Demographics
NPI:1538410063
Name:MONEMVASITIS, BRITTANY RYAN (PA)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:RYAN
Last Name:MONEMVASITIS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3277 JUDITH DR
Mailing Address - Street 2:
Mailing Address - City:BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-5410
Mailing Address - Country:US
Mailing Address - Phone:516-578-6081
Mailing Address - Fax:
Practice Address - Street 1:3277 JUDITH DR
Practice Address - Street 2:
Practice Address - City:BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710-5410
Practice Address - Country:US
Practice Address - Phone:516-578-6081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-24
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015950363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical