Individual
TAE JOEN LIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MASSAGE THERAPIST
Contact information
Practice address
215 HALLOCK RD STE 6A, STONY BROOK, NY 11790-3077
(917) 563-1824
Mailing address
215 HALLOCK RD STE 6A, STONY BROOK, NY 11790-3077
(917) 563-1824
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
027052
NY
Other
Enumeration date
10/29/2020
Last updated
10/29/2020
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