Individual
FALLON PANETTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
830 HARRIAD DR W, SEAFORD, NY 11783-1206
(917) 796-8642
Mailing address
830 HARRIAD DR W, SEAFORD, NY 11783-1206
(917) 796-8642
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/19/2017
Last updated
04/19/2017
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