Individual
STACY ANN MANGINI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
201 BAY SHORE RD, BAY SHORE, NY 11706-5327
(631) 665-6881
Mailing address
38 E OAKDALE ST, BAY SHORE, NY 11706-2726
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
019485
NY
Other
Enumeration date
06/15/2007
Last updated
07/08/2007
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