MEDICARE: MR. ANDREW NEWHOOOK 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	031694	NY

General Provider Information

NPI Number	:	1801503859
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ANDREW NEWHOOOK LMT

Provider Business Mailing Address
First Line	:	2453H UNION BLVD APT 29A
Second Line	:
City	:	ISLIP
State	:	NY
Zip	:	11751-3136
Country	:	US
Telephone Number	:	516-468-4005
Fax Number	:

Provider Business Practice Location Address
First Line	:	118 E 28TH ST RM 504
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10016-8446
Country	:	US
Telephone Number	:	516-468-4005
Fax Number	:

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

Provider Enumeration Date	:	10/31/2022
Last Update Date	:	10/31/2022

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