Individual
MRS. SUSANNA DE JESUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1147 DEER PARK AVE UNIT A, NORTH BABYLON, NY 11703-3103
(631) 402-4680
Mailing address
91 RYDER AVE, NORTH BABYLON, NY 11703-2223
(631) 935-3776
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
027958-1
NY
225700000X
Massage Therapist
—
NY
Other
Enumeration date
04/06/2021
Last updated
04/06/2021
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