Healthcare Provider Details

I. General information

NPI: 1801489240
Provider Name (Legal Business Name): FINGERS FROM HEAVEN INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2021
Last Update Date: 02/01/2022
Certification Date: 02/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

464 ROUTE 25A
MILLER PLACE NY
11764-2514
US

IV. Provider business mailing address

464 ROUTE 25A
MILLER PLACE NY
11764-2514
US

V. Phone/Fax

Practice location:
  • Phone: 631-680-9458
  • Fax: 631-736-1332
Mailing address:
  • Phone: 631-438-6682
  • Fax: 631-642-2195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CONNIE TJADEN
Title or Position: OWNER
Credential: D.AC, LMT
Phone: 631-438-6682