Individual
LIONEL GONDOLFO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
269 E MAIN ST, EAST ISLIP, NY 11730-2730
(631) 321-3493
Mailing address
3836 TIANA ST, SEAFORD, NY 11783-3550
(151) 652-1778
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
020909
NY
Other
Enumeration date
09/23/2019
Last updated
09/23/2019
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