Individual
DANIEL PETER PONTILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S.
Contact information
Practice address
650 MADISON ST, SYRACUSE, NY 13210-2319
(315) 426-7694
Mailing address
124 LONGWOOD DR, EAST SYRACUSE, NY 13057-1644
(315) 433-9177
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
002482
NY
Other
Enumeration date
04/06/2010
Last updated
04/06/2010
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