Individual
CARMELISA PORRETTO I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
222 N KINGS AVE, MASSAPEQUA, NY 11758-3324
(347) 406-4398
Mailing address
222 N KINGS AVE, MASSAPEQUA, NY 11758-3324
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
841455141
NY
Other
Enumeration date
07/22/2014
Last updated
07/22/2014
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