Individual
BRANDY ANN BISTANY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
30 OAKLAND AVE, PORT JEFFERSON, NY 11777-2171
(516) 639-4968
Mailing address
30 OAKLAND AVE, PORT JEFFERSON, NY 11777-2171
(516) 639-4968
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
018332
NY
Other
Enumeration date
10/20/2021
Last updated
10/20/2021
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