Individual
JEANMARIE NIZEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
703 MCCALL AVE, WEST ISLIP, NY 11795-3713
(631) 445-9360
Mailing address
703 MCCALL AVE, WEST ISLIP, NY 11795-3713
(631) 445-9360
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
014058-1
NY
Other
Enumeration date
11/10/2020
Last updated
11/10/2020
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