Jessica Degonzague
NPI #1104217256 in Ronkonkoma, New York
Provider Information
- NPI Number
- 1104217256
- Entity Type
- Individual
- Name
- Jessica Degonzague
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Specialist
- Enumeration Date
- Feb 11, 2015
- Last Updated
- Feb 11, 2015
Practice Location
- Address
- 90 AIR PARK DR
- City
- Ronkonkoma
- State
- New York
- ZIP Code
- 11779-7360
- Phone
- (631) 580-4001
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist |
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