Individual
MAURICIO PATINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
465 SHORE RD APT 6R, LONG BEACH, NY 11561-5338
(516) 761-5317
Mailing address
465 SHORE RD APT 6R, LONG BEACH, NY 11561-5338
(516) 761-5317
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
032223
NY
Other
Enumeration date
09/11/2020
Last updated
09/11/2020
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