Individual
MS. MADONNA FONTANILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
275 NORTH ST, HARRISON, NY 10528-1524
(914) 925-5211
Mailing address
275 NORTH ST, HARRISON, NY 10528-1524
(914) 925-5211
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
596069
NY
Other
Enumeration date
08/11/2009
Last updated
08/11/2009
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