Individual
DANIELLE MARIE DIVANNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
901 STEWART AVE STE 212, GARDEN CITY, NY 11530-4823
(516) 742-4422
Mailing address
16339 20TH RD, WHITESTONE, NY 11357-4024
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
063352
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/30/2022
Last updated
03/25/2024
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