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Individual

JESSICA CARBONARA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
61 ROUTE 111, SMITHTOWN, NY 11787-3712
(516) 885-4645
Mailing address
42 BAYLOR DR, SMITHTOWN, NY 11787-2002
(516) 885-4645

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
012311
NY

Other

Enumeration date
04/15/2026
Last updated
04/15/2026
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