Individual
SERENA MARIE LICASTRO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.MT
Contact information
Practice address
130 ROSE AVE, STATEN ISLAND, NY 10306-2241
(718) 909-3819
Mailing address
130 ROSE AVE, STATEN ISLAND, NY 10306-2241
(718) 909-3819
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
030763
NY
Other
Enumeration date
10/11/2024
Last updated
03/08/2026
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