Healthcare Provider Details

I. General information

NPI: 1225436645
Provider Name (Legal Business Name): HOT YOGA MASSAPEQUA INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2014
Last Update Date: 12/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5078A SUNRISE HWY
MASSAPEQUA PARK NY
11762-2926
US

IV. Provider business mailing address

5078A SUNRISE HWY
MASSAPEQUA PARK NY
11762-2926
US

V. Phone/Fax

Practice location:
  • Phone: 516-798-7980
  • Fax:
Mailing address:
  • Phone: 516-798-7980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. PATRICK HANRATTY
Title or Position: OWNER
Credential:
Phone: 516-798-7980