Healthcare Provider Details

I. General information

NPI: 1780526053
Provider Name (Legal Business Name): HUMAN RESTORATION PROJECT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2026
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 LINCOLN AVE UNIT 9
HOLBROOK NY
11741-2257
US

IV. Provider business mailing address

920 LINCOLN AVE UNIT 9
HOLBROOK NY
11741-2257
US

V. Phone/Fax

Practice location:
  • Phone: 631-571-9653
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: JOHNATHAN LAZNOVSKY
Title or Position: PRESIDENT
Credential:
Phone: 631-678-5684