Healthcare Provider Details

I. General information

NPI: 1093630857
Provider Name (Legal Business Name): SOUL ANCHOR THERAPEUTICS & ESTHETICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

334 AVENUE OF AMERICAS STE 400
NEW WINDSOR NY
12553-4752
US

IV. Provider business mailing address

8 CRANS RD
MIDDLETOWN NY
10941-5001
US

V. Phone/Fax

Practice location:
  • Phone: 845-420-0329
  • Fax:
Mailing address:
  • Phone: 845-420-0329
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JAMIE VESELY
Title or Position: OWNER
Credential:
Phone: 845-420-0329