NPI 1003391665

Maria Jean Mirissis, MASSAGETHERAPIST

Practitioner Massage Therapist Northport, NY

Practice location

Address: 10 Fort Salonga Rd STE 2a, Northport, NY 11768-1465
Phone: (631) 343-9194

Registered specialties

Massage Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225700000X Licence 006241 (NY)

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Registry record

NPI: 1003391665
Entity type: Individual
Sex (as registered): Female
NPI issued: 30 Sep 2018
Record last updated: 30 Sep 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.