Individual
MRS. SUZANNE PAVELOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
90 AIRPARK DRIVE, RONKONKOMA, NY 11779
(631) 580-4001
Mailing address
221 STUYVESANT DR, SELDEN, NY 11784-1225
(631) 335-4239
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
827294
NY
Other
Enumeration date
06/25/2014
Last updated
06/25/2014
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