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1790545200
JONATHAN DIVITO
JAMAICA, NY
NPI
1790545200
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2024-03-21
Last Update Date
2024-03-21
Business Address
JONATHAN DIVITO
8268 164TH ST
JAMAICA, NY 11432-1121
Phone number: 718-883-4583
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Mailing Address
JONATHAN DIVITO
8268 164TH ST
JAMAICA, NY 11432-1121
Phone number:
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