Individual
MICHAEL ANGEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5125 QUEENS BLVD, WOODSIDE, NY 11377-4594
(347) 659-3932
Mailing address
5125 QUEENS BLVD APT E3, WOODSIDE, NY 11377-4597
(347) 659-3932
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
029236
NY
Other
Enumeration date
10/10/2020
Last updated
10/10/2020
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