Individual
MS. DIANA LYNN PANULLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
380 WASHINGTON AVE, ROOSEVELT, NY 11575-1845
(516) 378-2000
Mailing address
PO BOX 7620, WANTAGH, NY 11793-7620
(516) 378-2000
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
002314-1
NY
Other
Enumeration date
11/17/2008
Last updated
11/17/2008
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