Individual
JUDITH DEVITO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
53345 MAIN RD, SOUTHOLD, NY 11971-4643
(631) 765-2100
Mailing address
25 ELM AVE, FLANDERS, NY 11901-4051
(631) 834-7300
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
024814-1
NY
Other
Enumeration date
03/06/2018
Last updated
03/06/2018
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