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NPI 1083555007

NPI 1083555007 : TRUSERENITYBYTANIYAHLYNNAE : METUCHEN, NJ

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General NPI Number Information
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    NPI Number           |    1083555007
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    Entity Type          |    Organization 
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    Legal Business Name  |    TRUSERENITYBYTANIYAHLYNNAE 
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Dates
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    Enumeration Date     |    04/03/2026
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    Last Update Date     |    04/03/2026
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Provider Practice Location Address
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    Address Line         |    73 AMBOY AVE 
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    City                 |    METUCHEN
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    State                |    NJ
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    Zip                  |    08840-2549
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    Country              |    US
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    Telephone            |    848-365-4030
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    831 W 8TH ST 
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    City                 |    PLAINFIELD
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    State                |    NJ
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    Zip                  |    07063-1539
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    Country              |    US
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    Telephone            |    929-379-3680
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    Fax                  |    
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Authorized Official
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    Title or Position    |    LMT
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    Name                 |     TANIYAH LYNNAE DUBOSE 
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    Credential           |    
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    Telephone            |    929-379-3680
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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       |    
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    License Number State |    
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