Individual
NANCY JEAN FENIMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
121 PULASKI RD, KINGS PARK, NY 11754-2539
(631) 455-9347
Mailing address
15 KINGSLAND AVE, EAST YAPHANK, NY 11967-1525
(631) 835-8007
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
032474
NY
Other
Enumeration date
04/15/2021
Last updated
04/15/2021
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