Individual
JONNATHAN M PINEDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
189 MAIN RD STE A, RIVERHEAD, NY 11901-1957
(631) 369-4323
(631) 369-4325
Mailing address
189 MAIN RD STE A, RIVERHEAD, NY 11901-1957
(631) 369-4323
(631) 369-4325
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
030875-01
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1447250261
NPI
NY
Enumeration date
07/16/2021
Last updated
07/16/2021
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