Nicol Lee Lutsky, LMT
Massage Therapist in Merrick, NY. Individual provider (NPI-1).
NPI number1154099331
StatusActive
Last updated in NPPESSep 1, 2021
Details
- NPI
- 1154099331
- Entity type
- Individual (NPI-1)
- Name
- Ms. Nicol Lee Lutsky
- Credential
- LMT
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 1, 2021
- Certification date
- Sep 1, 2021
- Last updated
- Sep 1, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225700000X | Massage Therapist | 014085-1 | NY | Yes |
Practice location
83 Wynsum AveMerrick, NY 11566-4036
Phone 631-838-2605
Mailing address
83 Wynsum AveMerrick, NY 11566-4036
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