Individual
NICOLE DERESPIRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2789 MILBURN AVE STE 3, BALDWIN, NY 11510-4119
(516) 754-1260
Mailing address
2789 MILBURN AVE FL 1, BALDWIN, NY 11510-4119
(516) 754-1260
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
008853-1
NY
Other
Enumeration date
08/29/2020
Last updated
08/29/2020
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