Individual
DIANA MARIE BASILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
34 HEMPSTEAD TPKE, FARMINGDALE, NY 11735-2034
(516) 755-5855
Mailing address
29 JOHNSON CT, EAST NORWICH, NY 11732-1301
(516) 922-7336
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
007004
NY
Other
Enumeration date
01/15/2020
Last updated
01/15/2020
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