Healthcare Provider Details

I. General information

NPI: 1205753092
Provider Name (Legal Business Name): ALYCEA KAREN SHIRLEY LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 E 231ST ST
BRONX NY
10466-4607
US

IV. Provider business mailing address

915 E 231ST ST
BRONX NY
10466-4607
US

V. Phone/Fax

Practice location:
  • Phone: 347-435-8393
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number031610
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: