Most Relevant Information
Provider Data
NPI Number: | 1003555103 |
Provider Name: | TIFFANY A SIACA |
Entity Type: | Individual |
Taxonomy Code: | 225700000X |
Specialty: | Massage Therapist |
License Number: | 030708-01 |
Most Important Dates
Enumeration Date: | 05/27/2022 |
Last Updated: | 05/27/2022 |
Provider Practice Location
935 N BROADWAY
N MASSAPEQUA
NY
117582308
Practice Location Phone/Fax
Phone: | 5167075915 |
Fax: |
Provider Mailing Location
935 N BROADWAY
N MASSAPEQUA
NY
117582308
Provider Mailing Phone/Fax
Phone: | |
Fax: |