Healthcare Provider Details

I. General information

NPI: 1225362262
Provider Name (Legal Business Name): CARLOS BAYERRI-ALBESA L.AC, LMT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2009
Last Update Date: 05/15/2024
Certification Date: 05/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

699 SACKETT ST GROUNDFLOOR
BROOKLYN NY
11217-4561
US

IV. Provider business mailing address

58 OVERLOOK PL # 2
NEWBURGH NY
12550-6311
US

V. Phone/Fax

Practice location:
  • Phone: 917-755-8950
  • Fax:
Mailing address:
  • Phone: 917-755-8950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number004185
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number023595-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: