Provider Demographics
NPI:1568725356
Name:CONETTA, TONIANN (MS ECE)
Entity Type:Individual
Prefix:
First Name:TONIANN
Middle Name:
Last Name:CONETTA
Suffix:
Gender:F
Credentials:MS ECE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2323 SEYMOUR AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-5739
Mailing Address - Country:US
Mailing Address - Phone:347-653-7404
Mailing Address - Fax:
Practice Address - Street 1:2323 SEYMOUR AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-5739
Practice Address - Country:US
Practice Address - Phone:347-653-7404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-18
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY171M00000XOtherSPECIALIST