Individual
DOUGLAS BAUTISTA SAGASTIZADO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
130 N CARLL AVE, BABYLON, NY 11702-2238
(631) 433-9502
Mailing address
130 N CARLL AVE, BABYLON, NY 11702-2238
(631) 433-9502
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
031765
NY
Other
Enumeration date
04/09/2021
Last updated
04/12/2021
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