Individual
LISA GANDOLFO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1139 CONEY ISLAND AVE, BROOKLYN, NY 11230-2305
(718) 724-1730
(718) 724-1735
Mailing address
1139 CONEY ISLAND AVE, BROOKLYN, NY 11230-2305
(718) 724-1730
(718) 724-1735
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
387742-1
LA
Other
Enumeration date
12/08/2016
Last updated
12/08/2016
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