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Individual

AUGUSTINA MARIA DIMILTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
624 HAWKINS AVE, RONKONKOMA, NY 11779-2375
(631) 240-3579
Mailing address
14607 17TH AVE, WHITESTONE, NY 11357-3015
(347) 924-8386

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary

Other

Enumeration date
08/28/2020
Last updated
08/28/2020
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