Individual
RICHARD TANZILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
H.I.S
Contact information
Practice address
21 W 2ND ST, RIVERHEAD, NY 11901-2752
(631) 369-2038
Mailing address
22 LAKE AVE, RONKONKOMA, NY 11779-4693
(631) 681-0960
(631) 369-2038
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
14000060305
NY
Other
Enumeration date
03/20/2020
Last updated
03/20/2020
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