Individual
GINO FRANCESCO PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S.ED
Contact information
Practice address
6 MELISSA DR, LAKE GROVE, NY 11755-2605
(631) 525-3415
Mailing address
6 MELISSA DR, LAKE GROVE, NY 11755-2605
(631) 525-3415
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
701656131
NY
Other
Enumeration date
07/30/2013
Last updated
07/30/2013
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