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1104217256
JESSICA DEGONZAGUE
RONKONKOMA, NY
NPI
1104217256
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
174400000X Specialist
Enumeration Date
2015-02-11
Last Update Date
2015-02-11
Business Address
-- JESSICA DEGONZAGUE
90 AIR PARK DR
RONKONKOMA, NY 11779-7360
Phone number: 631-580-4001
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Mailing Address
-- JESSICA DEGONZAGUE
6 BIRCH AVE
SOUND BEACH, NY 11789-2534
Phone number:
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