Most Relevant Information
Provider Data
| NPI Number: | 1003328519 |
| Provider Name: | BRANDY LEE NICASTRO LMT |
| Entity Type: | Individual |
| Taxonomy Code: | 225700000X |
| Specialty: | Massage Therapist |
| License Number: | 015586-1 |
Most Important Dates
| Enumeration Date: | 10/25/2017 |
| Last Updated: | 10/25/2017 |
Provider Practice Location
10688 ALLEGHANY RD
DARIEN CENTER
NY
14040
Practice Location Phone/Fax
| Phone: | 7166970915 |
| Fax: |
Provider Mailing Location
10688 ALLEGHANY RD
DARIEN CENTER
NY
140409743
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |