MEDICARE: LENOX HILL MASSAGE AND PHYSICAL THERAPY PLLC

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
1	225700000X	Massage Therapist
2	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1154687036
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LENOX HILL MASSAGE AND PHYSICAL THERAPY PLLC

Provider Business Mailing Address
First Line	:	261 E 78TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10075-1216
Country	:	US
Telephone Number	:	212-650-1620
Fax Number	:	212-650-1689

Provider Business Practice Location Address
First Line	:	261 E 78TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10075-1216
Country	:	US
Telephone Number	:	212-650-1620
Fax Number	:	212-650-1689

Authorized Official
Title or Position	:	CEO
Name	:	YEVGENIY SAZONOV
Credential	:
Telephone Number	:	917-207-1529

Provider Enumeration Date	:	04/05/2012
Last Update Date	:	04/05/2012

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