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Individual

DR. LUZ S FONACIER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
120 MINEOLA BLVD, SUITE 410, MINEOLA, NY 11501-4073
(516) 663-4751
(516) 663-2946
Mailing address
120 MINEOLA BLVD, SUITE 410, MINEOLA, NY 11501-4073
(516) 663-4751
(516) 663-2946

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
NYS164053
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01207652
NY
Enumeration date
11/08/2005
Last updated
03/31/2021
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