Individual
ROSE PANICCIOLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
314 JEFFERSON AVE, STATEN ISLAND, NY 10306-5223
(917) 439-6418
Mailing address
314 JEFFERSON AVE, STATEN ISLAND, NY 10306-5223
(917) 439-6418
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
06/07/2012
Last updated
06/07/2012
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