Individual
LISSETTE ANDRAMUNO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10963 54TH AVE, CORONA, NY 11368-1576
(718) 414-9959
Mailing address
10963 54TH AVE # 3, CORONA, NY 11368-3337
(718) 414-9959
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
016565-1
NY
Other
Enumeration date
03/13/2011
Last updated
05/02/2014
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