Healthcare Provider Details

I. General information

NPI: 1073109229
Provider Name (Legal Business Name): NEW HEALING TOUCH MASSAGE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2020
Last Update Date: 12/11/2020
Certification Date: 12/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 SECATOGUE AVE
FARMINGDALE NY
11735-4335
US

IV. Provider business mailing address

535 SECATOGUE AVE
FARMINGDALE NY
11735-4335
US

V. Phone/Fax

Practice location:
  • Phone: 516-603-5807
  • Fax:
Mailing address:
  • Phone: 516-603-5807
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. CALVIN H CANALES
Title or Position: LMT
Credential:
Phone: 516-603-5807