Individual
TERRY PONTINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
475 E MAIN ST, EAST PATCHOGUE, NY 11772
(631) 475-7700
(631) 307-9911
Mailing address
475 E MAIN ST, EAST PATCHOGUE, NY 11772-3121
(631) 475-7700
(631) 307-9911
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
431103
NY
Other
Enumeration date
03/01/2012
Last updated
08/22/2018
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