Healthcare Provider Details
I. General information
NPI: 1881274413
Provider Name (Legal Business Name): BARBARA OHAYON LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/08/2021
Last Update Date: 04/08/2021
Certification Date: 04/08/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
42 N SHORE RD
MONTAUK NY
11954-5074
US
IV. Provider business mailing address
PO BOX 1146
MONTAUK NY
11954-0898
US
V. Phone/Fax
- Phone: 631-786-4908
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225700000X |
| Taxonomy | Massage Therapist |
| License Number | 012088 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: