Organization
CM SPA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CONCETTA ANGELA MANGIARACINA DDS (OWNER)
(516) 659-1913
Entity
Organization
Contact information
Practice address
1955 MERRICK RD STE 101, MERRICK, NY 11566-4615
(516) 659-1913
Mailing address
1955 MERRICK RD STE 101, MERRICK, NY 11566-4615
(516) 659-1913
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1265661102
INDIVIDUAL NPI
NY
Enumeration date
07/28/2022
Last updated
07/28/2022
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