Healthcare Provider Details

I. General information

NPI: 1346160850
Provider Name (Legal Business Name): LIVIA ZIMMERMAN
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3020 SEVEN LAKES DRIVE
BEAR MOUNTAIN NY
10911
US

IV. Provider business mailing address

41 RAYMOND AVE
POUGHKEEPSIE NY
12603-7900
US

V. Phone/Fax

Practice location:
  • Phone: 845-233-2152
  • Fax:
Mailing address:
  • Phone: 845-288-3117
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number034025
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: