NICHOLAS DEROSA

BOHEMIA, NY
NPI1740327204
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy235Z00000X Speech-Language Pathologist,
(Licence: NY  013111-1)
Enumeration Date2007-01-31
Last Update Date2007-07-08
Business Address
-- NICHOLAS DEROSA
45 CROSSWAY E
BOHEMIA, NY 11716-1204
Phone number: 631-218-4949
Mailing Address
-- NICHOLAS DEROSA
422 MYRTLE AVE
WEST ISLIP, NY 11795-4115
Phone number:
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