Individual
MR. DERON GLENN D'AVANZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2778 BRUCKNER BLVD, BRONX, NY 10465-1934
(718) 863-4925
Mailing address
2778 BRUCKNER BLVD, BRONX, NY 10465-1934
(718) 863-4925
Taxonomy
Speciality
Code
Description
License number
State
101YS0200X
School Counselor
Primary
—
—
Other
Enumeration date
07/31/2012
Last updated
07/31/2012
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