Healthcare Provider Details

I. General information

NPI: 1306009154
Provider Name (Legal Business Name): RAQUEL SIMILIO L.AC, LMT, CLT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2008
Last Update Date: 10/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 FT WASHINGTN AVE
NEW YORK NY
10032-3729
US

IV. Provider business mailing address

4410 BROADWAY APT 4H
NEW YORK NY
10040-4084
US

V. Phone/Fax

Practice location:
  • Phone: 212-305-8029
  • Fax:
Mailing address:
  • Phone: 646-325-6913
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number019508-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number004960-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: