Individual
MS. REGINA M TART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
640 BELLE TERRE RD, PORT JEFFERSON, NY 11777-1936
(631) 828-5361
Mailing address
14 CHURCH LN, MIDDLE ISLAND, NY 11953-1706
(631) 905-8558
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005203
COMMERCIAL INSURANCE
NY
Enumeration date
09/12/2022
Last updated
09/12/2022
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