Individual
MRS. LOUISE ANN MONGELLUZZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
52 ARTILLERY LN, BALDWINSVILLE, NY 13027-1146
(315) 652-3518
Mailing address
52 ARTILLERY LN, BALDWINSVILLE, NY 13027-1146
(315) 652-3518
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
008973-1
NY
Other
Enumeration date
11/15/2007
Last updated
11/15/2007
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