Individual
MR. BART GERARD PONTECORVO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
40 DRAKE RD, CENTEREACH, NY 11720-2306
(631) 241-4021
(631) 470-7825
Mailing address
40 DRAKE RD, CENTEREACH, NY 11720-2306
(631) 241-4021
(631) 470-7825
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
004532-1
NY
Other
Enumeration date
09/11/2008
Last updated
09/11/2008
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