Individual
GINA MARIE MATTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
11 EMERSON AVE, LEVITTOWN, NY 11756-5705
(631) 333-9004
Mailing address
11 EMERSON AVE, LEVITTOWN, NY 11756-5705
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
024385
NY
225700000X
Massage Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
024385
LICENSE
NY
Enumeration date
11/20/2021
Last updated
11/20/2021
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