Individual
PAT BIVONA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7 KATHRYN LN, RONKONKOMA, NY 11779-5705
(631) 312-0365
Mailing address
7 KATHRYN LN, RONKONKOMA, NY 11779-5705
(631) 312-0365
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1249755
NY
Other
Enumeration date
08/19/2014
Last updated
08/19/2014
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