Healthcare Provider Details

I. General information

NPI: 1386861458
Provider Name (Legal Business Name): ERIN SUE HURME DAOM, LAC, LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 11/24/2020
Certification Date: 11/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 BROADWAY
AMITYVILLE NY
11701-2705
US

IV. Provider business mailing address

209 BROADWAY
AMITYVILLE NY
11701-2705
US

V. Phone/Fax

Practice location:
  • Phone: 631-691-0200
  • Fax: 631-691-0202
Mailing address:
  • Phone: 516-578-9028
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number014307-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number37031
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: