Healthcare Provider Details

I. General information

NPI: 1215239454
Provider Name (Legal Business Name): TROPICAL RAINFOREST MASSAGE THERAPY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2010
Last Update Date: 11/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

248 JEFFERSON AVE
BROOKLYN NY
11216-1709
US

IV. Provider business mailing address

248 JEFFERSON AVE
BROOKLYN NY
11216-1709
US

V. Phone/Fax

Practice location:
  • Phone: 718-755-0620
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number0092901
License Number StateNY

VIII. Authorized Official

Name: ELIZABETH ANCION
Title or Position: MASSAGE THERAPIST
Credential: LMT
Phone: 718-755-0620