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1710258454
MICHAEL FORMATO
MASSAPEQUA, NY
NPI
1710258454
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
174400000X Specialist
(Licence: NY 0141391)
Enumeration Date
2012-01-25
Last Update Date
2012-01-25
Business Address
Mr. MICHAEL FORMATO MS OTR/L
101 PAGET LN
MASSAPEQUA, NY 11758-3752
Phone number: 516-541-1664
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Mailing Address
Mr. MICHAEL FORMATO MS OTR/L
101 PAGET LN
MASSAPEQUA, NY 11758-3752
Phone number: 516-541-1664
Copy
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