Healthcare Provider Details

I. General information

NPI: 1194649095
Provider Name (Legal Business Name): POSITIVE OUTCOME 2020 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 MADISON AVE RM 1102
NEW YORK NY
10022-5497
US

IV. Provider business mailing address

515 MADISON AVE RM 1102
NEW YORK NY
10022-5497
US

V. Phone/Fax

Practice location:
  • Phone: 347-762-6416
  • Fax: 929-295-7086
Mailing address:
  • Phone: 347-762-6416
  • Fax: 929-295-7086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: MELANIE MORALES
Title or Position: OWNER
Credential: LMT
Phone: 347-707-3441