Individual
ROSALYNN BRISTOL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
33 TOWN HOUSE DR, MASSAPEQUA PARK, NY 11762-1162
(917) 440-6743
Mailing address
33 TOWN HOUSE DR, MASSAPEQUA PARK, NY 11762-1162
(917) 440-6743
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
02/06/2017
Last updated
02/06/2017
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