Individual
CHRISTY MARIE GORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15 ELEANOR DR, NORTH MASSAPEQUA, NY 11758-1005
(516) 342-9933
Mailing address
15 ELEANOR DR, NORTH MASSAPEQUA, NY 11758-1005
(516) 342-9933
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
06/27/2012
Last updated
06/27/2012
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