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Individual

DAMON V TARANTOLA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
65-29 GRAND AVE, MASPETH, NY 11378
(718) 846-9821
(718) 846-9527
Mailing address
65-29 GRAND AVE, MASPETH, NY 11378
(718) 846-9821
(718) 846-9527

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Enumeration date
12/17/2019
Last updated
12/17/2019
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