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General NPI Number Information
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NPI Number | 1154600831
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Entity Type | Organization
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Legal Business Name | FOR YOURSELF HOLISTIC REJUVENATION CENTER
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Dates
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Enumeration Date | 08/11/2011
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Last Update Date | 08/11/2011
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Provider Practice Location Address
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Address Line | 2990 MERRICK RD
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City | BELLMORE
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State | NY
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Zip | 11710-5760
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Country | US
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Telephone | 516-308-3463
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Fax | 516-308-3462
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Provider Business Mailing Address
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Address Line | 2990 MERRICK RD
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City | BELLMORE
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State | NY
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Zip | 11710-5760
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Country | US
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Telephone | 516-308-3463
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Fax | 516-308-3462
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Authorized Official
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Title or Position | OWNER
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Name | MS. MARIANNE MARCHESE-ZAM
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Credential | L.AC, RN
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Telephone | 516-308-3463
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 003066
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License Number State | NY
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