Individual
EMILY NICOLE BAGNASCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
827 S 5TH ST, LINDENHURST, NY 11757-5625
(631) 521-0892
Mailing address
827 S 5TH ST, LINDENHURST, NY 11757-5625
(631) 521-0892
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
029276
NY
Other
Enumeration date
11/04/2020
Last updated
11/04/2020
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