Individual
MR. CHRIS ROBERT MUSCOLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2900 HEMPSTEAD TPKE, LEVITTOWN, NY 11756-1404
(631) 366-3876
Mailing address
762 ERIE ST, RONKONKOMA, NY 11779-6051
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
723454
NY
Other
Enumeration date
06/26/2012
Last updated
06/27/2012
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