Individual
TOM DOLISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
350 S WELLWOOD AVE, LINDENHURST, NY 11757-4928
(631) 867-6531
Mailing address
350 S WELLWOOD AVE, LINDENHURST, NY 11757-4928
(631) 867-6531
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
026090
NY
Other
Enumeration date
09/14/2012
Last updated
09/14/2012
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