Individual
ANGELENE RONQUILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ST
Contact information
Practice address
2209 GENESEE ST, UTICA, NY 13501-5930
(315) 798-8160
(315) 798-8397
Mailing address
2209 GENESEE ST, UTICA, NY 13501-5930
(315) 798-8160
(315) 798-8397
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
011564-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00279901
—
NY
Enumeration date
07/16/2006
Last updated
07/09/2007
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