Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 032543 | NY |
NPI | 1003481284 |
---|---|
Provider Name | Mr. Xiaolong Zhang |
First Address | Flushing, NY 11354-6194 |
Second Address | South Farmingdale, NY 11735-2034 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2021 |
Last Update Date | 21/05/2021 |