Individual
TATIANA V GOSTEV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MASSAGE THERAPIST
Contact information
Practice address
13-02 FAIR LAWN AVE, FAIR LAWN, NJ 07410-2229
(917) 517-9783
Mailing address
13-02 FAIR LAWN AVE, FAIR LAWN, NJ 07410-2229
(917) 517-9783
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
026383
NY
Other
Enumeration date
09/01/2020
Last updated
09/01/2020
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