Individual
DANA PERDOMO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
417 S 6TH ST, LINDENHURST, NY 11757-4636
(631) 926-1908
Mailing address
417 S 6TH ST, LINDENHURST, NY 11757-4636
(631) 926-1908
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
869150
NY
Other
Enumeration date
07/03/2013
Last updated
07/03/2013
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