Healthcare Provider Details

I. General information

NPI: 1528607579
Provider Name (Legal Business Name): SARAH SHOU HEN ESKUE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/21/2019
Last Update Date: 12/21/2019
Certification Date: 12/21/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 E 49TH ST LBBY E
NEW YORK NY
10017-1680
US

IV. Provider business mailing address

2239 TROY AVE APT 4O
BROOKLYN NY
11234-3637
US

V. Phone/Fax

Practice location:
  • Phone: 785-498-9318
  • Fax:
Mailing address:
  • Phone: 785-498-9318
  • Fax: 833-963-1433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number014634
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: