Individual
MIAOMIAO GONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
248 LARKFIELD RD STE C, EAST NORTHPORT, NY 11731-2443
(631) 985-7770
Mailing address
22511 59TH AVE FL 2, OAKLAND GDNS, NY 11364-2312
(646) 215-0910
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
032286
NY
225700000X
Massage Therapist
—
NY
Other
Enumeration date
05/31/2024
Last updated
09/20/2024
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