Healthcare Provider Details

I. General information

NPI: 1205227543
Provider Name (Legal Business Name): JILL SEALEE L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2015
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 EASTERN PKWY
BROOKLYN NY
11238-6141
US

IV. Provider business mailing address

60 PLAZA ST E APT 2F
BROOKLYN NY
11238-5028
US

V. Phone/Fax

Practice location:
  • Phone: 917-993-0597
  • Fax:
Mailing address:
  • Phone: 917-993-0597
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number025842-01
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number25-005410
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: