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NPI Code Detail

MEDICARE: EWING MASSAGE ENTERPRISES LLC

MEDICARE: EWING MASSAGE ENTERPRISES LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage Therapist

General Provider Information

NPI Number : 1013771930
Entity Type Code : Organization
Provider Name (Legal Business Name) : EWING MASSAGE ENTERPRISES LLC
Provider Business Mailing Address
First Line : 520 W 43RD ST APT 29A
Second Line :
City : NEW YORK
State : NY
Zip : 10036-4449
Country : US
Telephone Number : 201-401-1801
Fax Number :
Provider Business Practice Location Address
First Line : 525 W 42ND ST
Second Line :
City : NEW YORK
State : NY
Zip : 10036-6205
Country : US
Telephone Number : 201-401-1801
Fax Number :
Authorized Official
Title or Position : OWNER
Name : RITA EWING
Credential : REGISTERED NURSE
Telephone Number : 201-401-1801
Provider Enumeration Date : 02/12/2024
Last Update Date : 02/12/2024

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Directions to “EWING MASSAGE ENTERPRISES LLC ” Practice Location

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