Individual
GINO ANTHONY LONTRATO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
39 VIALL AVE, MECHANICVILLE, NY 12118-1032
(518) 269-0011
(518) 708-8780
Mailing address
39 VIALL AVE, MECHANICVILLE, NY 12118-1032
(518) 269-0011
(518) 708-8780
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
577496321
NY
Other
Enumeration date
12/15/2020
Last updated
01/19/2021
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