Healthcare Provider Details
I. General information
NPI: 1043454283
Provider Name (Legal Business Name): DHARMA HEALING ARTS MASSAGE THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/30/2009
Last Update Date: 04/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
331 COURT ST
BROOKLYN NY
11231-4410
US
IV. Provider business mailing address
331 COURT ST
BROOKLYN NY
11231-4410
US
V. Phone/Fax
- Phone: 718-237-3139
- Fax: 718-237-2169
- Phone: 718-237-3139
- Fax: 718-237-2169
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225700000X |
| Taxonomy | Massage Therapist |
| License Number | 018765 |
| License Number State | NY |
VIII. Authorized Official
Name:
LAUREN
SWEENEY-HAMPEL
Title or Position: OWNER
Credential: LMT
Phone: 718-237-3139