Individual
JILL DEBLANCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5 TERRA PINES GATE, YAPHANK, NY 11980-1807
(631) 775-8040
Mailing address
5 TERRA PINES GATE, YAPHANK, NY 11980-1807
(631) 775-8040
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
782555
NY
Other
Enumeration date
07/09/2012
Last updated
07/09/2012
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