Individual
MS. KAYLA ILOWITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
90 AIR PARK DR, RONKONKOMA, NY 11779-7360
(631) 560-9227
Mailing address
2372 1ST AVE, RONKONKOMA, NY 11779-6245
(631) 560-9227
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
912370151
NY
Other
Enumeration date
05/11/2015
Last updated
05/11/2015
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