Healthcare Provider Details

I. General information

NPI: 1437532520
Provider Name (Legal Business Name): ADRIANNE ZATE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2015
Last Update Date: 05/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

390 LAKE AVE S
NESCONSET NY
11767-1866
US

IV. Provider business mailing address

390 LAKE AVE S
NESCONSET NY
11767-1866
US

V. Phone/Fax

Practice location:
  • Phone: 516-606-7474
  • Fax:
Mailing address:
  • Phone: 516-606-7474
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number028107
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: