DOMINICK DISTASIO

SMITHTOWN, NY
NPI1740714930
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Enumeration Date2017-04-14
Last Update Date2017-04-14
Business Address
-- DOMINICK DISTASIO
11 ROUTE 111
SMITHTOWN, NY 11787-3754
Phone number: 631-920-8028
Mailing Address
-- DOMINICK DISTASIO
5 HUDSON DR
KINGS PARK, NY 11754-4411
Phone number:
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