Individual
ANIELL TOMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
90 AIR PARK DR, RONKONKOMA, NY 11779-7360
(631) 580-4001
Mailing address
12 CEDAR DRIVE, STONY BROOK, NY 11790
(631) 580-4001
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
03519300
NY
Other
Enumeration date
01/07/2014
Last updated
01/07/2014
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