Individual
PETRINA LOREE DEROBERTIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1305 MIDDLE COUNTRY RD, SELDEN, NY 11784-2554
(631) 880-3810
Mailing address
29 HIGH ST, SAYVILLE, NY 11782-1333
(631) 903-1104
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
029913-1
NY
Other
Enumeration date
05/08/2018
Last updated
06/21/2023
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