Individual
STACEY LEE BOLEMBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8804 3RD AVE, BROOKLYN, NY 11209-5664
(718) 921-6100
Mailing address
8804 3RD AVE, BROOKLYN, NY 11209-5664
(917) 982-4572
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
030787-01
NY
Other
Enumeration date
02/17/2025
Last updated
02/17/2025
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