Healthcare Provider Details

I. General information

NPI: 1821847195
Provider Name (Legal Business Name): BH MASSAGE SERVICE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2024
Last Update Date: 05/17/2024
Certification Date: 05/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8425 BAY 16TH ST
BROOKLYN NY
11214-2847
US

IV. Provider business mailing address

8425 BAY 16TH ST
BROOKLYN NY
11214-2847
US

V. Phone/Fax

Practice location:
  • Phone: 646-525-7303
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code172M00000X
TaxonomyMechanotherapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: BO HU
Title or Position: OWNER
Credential:
Phone: 646-525-7303