Individual
MARIO FUNICELLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1931 RICHMOND AVE, STATEN ISLAND, NY 10314-3889
(718) 477-9300
(718) 477-9301
Mailing address
1931 RICHMOND AVE, STATEN ISLAND, NY 10314-3889
(718) 477-9300
(718) 477-9301
Taxonomy
Speciality
Code
Description
License number
State
111NN0400X
Neurology Chiropractor
Primary
X007427-1
NY
Other
Enumeration date
02/23/2007
Last updated
08/29/2014
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