Healthcare Provider Details

I. General information

NPI: 1205371408
Provider Name (Legal Business Name): MUSIC HANDS WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2016
Last Update Date: 04/19/2021
Certification Date: 04/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 WASHINGTON AVENUE APT. SIDE
PATCHOGUE NY
11772
US

IV. Provider business mailing address

338 87TH ST #2F
BROOKLYN NY
11209-5147
US

V. Phone/Fax

Practice location:
  • Phone: 347-782-8058
  • Fax:
Mailing address:
  • Phone: 347-782-8058
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number026048
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MS. CHISATO TSUJI
Title or Position: FOUNDER
Credential: LMT
Phone: 347-782-8058