Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 021813 | NY |
NPI | 1013292598 |
---|---|
Provider Name | Janine M. Ertel-Graziano |
First Address | Cheektowaga, NY 14225-3261 |
Second Address | Lancaster, NY 14086-1262 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2011 |
Last Update Date | 17/10/2011 |