Antonella Modruson

NPI 1750698080 - Speech-Language Pathologist - 235Z00000X

NPI Details
NPI 1750698080
Gender Female
Enumeration Date 09/08/2010
Last Updated 09/08/2010
Entity Type Individual
Active Over 6 years ago
Practice Location
144 COVERT AVE
ELMONT NY, 11003-1138, US
Phone (516) 326-5560
Fax
Business Location
26 HASTINGS DR
FORT SALONGA NY, 11768-2509, US
Phone (631) 239-1767
Fax
Toxanomy
Taxonomy Code 235Z00000X
License State New York
License Number 58 015880
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According to our database, Mrs. Antonella Modruson NPI is 1750698080, taxonomy code is 235Z00000X and license number is 58 015880, license state is located at New York. Antonella Modruson physically located at 144 Covert Ave, Elmont NY, 11003-1138. NPI Number Antonella Modruson has the Individual type.

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1750698080 NPI number is provided on an as is basis without warranty of any kind. 1750698080 is maintained by the National Plan & Provider Enumeration System. The contents of Antonella Modruson are for informational purposes only.