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MRS. LUCILLE POLIDORO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
TEACHER

Contact information

Practice address
15 HARVARD DR, WOODBURY, NY 11797-3306
(347) 432-1545
Mailing address
15 HARVARD DR, WOODBURY, NY 11797-3306
(347) 432-1545

Taxonomy

Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
590249051
NY
252Y00000X
Early Intervention Provider Agency
NY

Other

Enumeration date
11/05/2015
Last updated
08/19/2021
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