Provider Demographics
NPI:1588208573
Name:TRONGONE, GINA ANN (LMT)
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:ANN
Last Name:TRONGONE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 RENEE GATE ST STE 5
Mailing Address - Street 2:
Mailing Address - City:CORTLANDT MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10567-1414
Mailing Address - Country:US
Mailing Address - Phone:914-528-7878
Mailing Address - Fax:914-528-7991
Practice Address - Street 1:2 RENEE GATE ST
Practice Address - Street 2:
Practice Address - City:CORTLANDT MANOR
Practice Address - State:NY
Practice Address - Zip Code:10567-1414
Practice Address - Country:US
Practice Address - Phone:914-528-7878
Practice Address - Fax:914-528-7991
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-01
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024235-1225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist