Individual
SANTOS SUSANA RIVAS-ZAVALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
209 BROADWAY, AMITYVILLE, NY 11701-2705
(631) 691-0200
Mailing address
75 MIRAMAR BLVD, LINDENHURST, NY 11757-6417
(516) 859-5996
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
031358-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000000000
N/A
NY
Enumeration date
08/08/2019
Last updated
08/08/2019
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