Individual
DEBRA WANTUCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AU.D., FAAA, CCC-A
Contact information
Practice address
47-48 196 STREET, FLUSHING, NY 11358
(718) 357-4682
Mailing address
47-48 196 STREET, FLUSHING, NY 11358
(718) 357-4682
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
000880-1
NY
Other
Enumeration date
12/03/2008
Last updated
12/03/2008
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