Individual
REBECCA FONTANETTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
755 NEW YORK AVE STE 230, HUNTINGTON, NY 11743-4285
(631) 505-3671
Mailing address
31 HENNESSEY DR, HUNTINGTON, NY 11743-3826
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
022179
NY
Other
Enumeration date
01/28/2020
Last updated
01/28/2020
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