Individual
MR. EDMUND SALVATORE IPPOLITO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
70 CORBIN AVE, SUITE I, BAY SHORE, NY 11706-1039
(631) 392-4050
Mailing address
70 CORBIN AVE, SUITE I, BAY SHORE, NY 11706-1039
(631) 392-4050
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
—
—
Other
Enumeration date
02/25/2011
Last updated
02/25/2011
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