Individual
ERIC MASTANDUONO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
269 MERRICK RD, LYNBROOK, NY 11563-2615
(516) 242-6255
Mailing address
269 MERRICK RD, LYNBROOK, NY 11563-2615
Taxonomy
Speciality
Code
Description
License number
State
1223X0008X
Oral and Maxillofacial Radiology Dentistry
Primary
063527
NY
Other
Enumeration date
01/10/2025
Last updated
01/10/2025
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