Individual
MRS. LUCILLE A GANGI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSED
Contact information
Practice address
32 PINE RD, MASTIC BEACH, NY 11951-2333
(631) 281-5142
Mailing address
32 PINE RD, MASTIC BEACH, NY 11951-2333
(631) 281-5142
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
NY
Other
Enumeration date
03/12/2013
Last updated
03/12/2013
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