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General NPI Number Information
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NPI Number | 1033626767
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Entity Type | Individual
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Provider Name | LINEESA SITARA RAMADHIN
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Gender | Female
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Dates
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Enumeration Date | 01/03/2018
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Last Update Date | 01/03/2018
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Provider Practice Location Address
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Address Line | 18 WEEKS ST
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City | BLUE POINT
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State | NY
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Zip | 11715-1513
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Country | US
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Telephone | 631-419-6300
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Fax | 631-419-6300
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Provider Business Mailing Address
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Address Line | 123 ROCKAWAY ST
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City | ISLIP TERRACE
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State | NY
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Zip | 11752-1018
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Country | US
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Telephone | 631-708-7895
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 029704
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License Number State | NY
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