Individual
NOEMI MIRANDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10 LEACH ST, LYNBROOK, NY 11563-2417
(347) 472-2736
Mailing address
10 LEACH ST, LYNBROOK, NY 11563-2417
(347) 472-2736
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
021393-1
NY
Other
Enumeration date
09/10/2019
Last updated
09/10/2019
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