Individual
ANNA SHAGALOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4-25 BRENNAN CT, FAIR LAWN, NJ 07410-5630
(718) 938-0658
Mailing address
4-25 BRENNAN CT, FAIR LAWN, NJ 07410-5630
(718) 938-0658
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
18KT01477700
NJ
Other
Enumeration date
12/04/2023
Last updated
01/20/2024
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