Individual
GINA M MAZZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
220 FORT SALONGA RD, NORTHPORT, NY 11768-3900
(917) 741-0687
Mailing address
220 FORT SALONGA RD, NORTHPORT, NY 11768-3900
(917) 741-0687
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
018362
NY
Other
Enumeration date
10/26/2022
Last updated
10/26/2022
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