Liana Jon Antonucci

NPI #1033687470 in Bayside, New York

Provider Information

NPI Number: 1033687470
Entity Type: Individual
Name: Liana Jon Antonucci
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Enumeration Date: Nov 3, 2018
Last Updated: Nov 3, 2018

Practice Location

Address: 21408 40TH AVE
City: Bayside
State: New York
ZIP Code: 11361-2117
Phone: (845) 558-8814

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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