Individual
PAUL ROSERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
430 N COUNTRY RD, SAINT JAMES, NY 11780-1759
(631) 697-4576
Mailing address
35 LEON PL, DEER PARK, NY 11729-1206
(631) 697-4576
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
027817-1
NY
Other
Enumeration date
05/28/2014
Last updated
03/17/2018
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