Individual
TIFFANY A SIACA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
935 N BROADWAY, N MASSAPEQUA, NY 11758-2308
(516) 707-5915
Mailing address
935 N BROADWAY, N MASSAPEQUA, NY 11758-2308
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
030708-01
NY
Other
Enumeration date
05/27/2022
Last updated
05/27/2022
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