MEDICARE: YASNARY CONTRERAS LMT

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	028645-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	028645	OTHER	NY	OFFICE OF THE PROFESSIONS

General Provider Information

NPI Number	:	1598349862
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YASNARY CONTRERAS LMT

Provider Business Mailing Address
First Line	:	2487 GRAND AVE APT 6A
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10468-5130
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2487 GRAND AVE APT 6A
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10468-5130
Country	:	US
Telephone Number	:	347-430-2050
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2021
Last Update Date	:	05/11/2021

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Directions to “ YASNARY CONTRERAS LMT” Practice Location

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