Individual
JENNIFER PORTARO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
49 NEW WOODS RD, GLEN COVE, NY 11542-1481
(516) 410-2942
Mailing address
49 NEW WOODS RD, GLEN COVE, NY 11542-1481
(516) 410-2942
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
07/23/2012
Last updated
07/23/2012
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