Individual
MRS. IRTA BRAZIENE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1717 VETERANS MEMORIAL HWY, ISLANDIA, NY 11749-1532
(631) 203-4300
Mailing address
106 W 5TH ST, RONKONKOMA, NY 11779-3843
(631) 738-0208
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
018974-01
NY
Other
Enumeration date
07/02/2020
Last updated
07/02/2020
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