Healthcare Provider Details

I. General information

NPI: 1730569526
Provider Name (Legal Business Name): NY HEALING, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2015
Last Update Date: 06/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 W 57TH ST SUITE 1201
NEW YORK NY
10019-2802
US

IV. Provider business mailing address

57 W 57TH ST SUITE 1201
NEW YORK NY
10019-2802
US

V. Phone/Fax

Practice location:
  • Phone: 212-757-1212
  • Fax:
Mailing address:
  • Phone: 212-757-1212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number1376
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number21276
License Number StateNY

VIII. Authorized Official

Name: SEAN PATRICK LILLIS
Title or Position: DIRECTOR
Credential: N.P.
Phone: 212-877-5500