Individual
MRS. KRISTINE IANNUCCI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT ASSISTANT
Contact information
Practice address
570 CENTRE AVE, LINDENHURST, NY 11757-3113
(631) 987-0857
Mailing address
570 CENTRE AVE, LINDENHURST, NY 11757-3113
(631) 987-0857
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
006241
NY
Other
Enumeration date
02/21/2008
Last updated
03/17/2011
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