Provider Demographics
NPI:1609696707
Name:VALENTIN, MILISSA ANN (LMT)
Entity type:Individual
Prefix:MRS
First Name:MILISSA
Middle Name:ANN
Last Name:VALENTIN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:257 N SUNRISE SERVICE RD
Mailing Address - Street 2:
Mailing Address - City:MANORVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11949-9602
Mailing Address - Country:US
Mailing Address - Phone:631-433-6573
Mailing Address - Fax:
Practice Address - Street 1:257 N SUNRISE SERVICE RD
Practice Address - Street 2:
Practice Address - City:MANORVILLE
Practice Address - State:NY
Practice Address - Zip Code:11949-9602
Practice Address - Country:US
Practice Address - Phone:631-433-6573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-14
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist