Individual
TERESELLA M GONDOLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
40-08 B FORLEY STREET, ELMHURST, NY 11373
(718) 803-2400
(718) 803-2636
Mailing address
PO BOX 1393, NEW YORK, NY 10028
(718) 803-2400
(718) 803-2436
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
194211
NY
Other
Enumeration date
05/27/2006
Last updated
09/07/2007
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