=====================================================
General NPI Number Information
=====================================================
NPI Number | 1194649095
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | POSITIVE OUTCOME 2020 LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/05/2026
-----------------------------------------------------
Last Update Date | 08/05/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 515 MADISON AVE RM 1102
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10022-5497
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 347-762-6416
-----------------------------------------------------
Fax | 929-295-7086
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 515 MADISON AVE RM 1102
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10022-5497
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 347-762-6416
-----------------------------------------------------
Fax | 929-295-7086
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MELANIE MORALES
-----------------------------------------------------
Credential | LMT
-----------------------------------------------------
Telephone | 347-707-3441
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225700000X
-----------------------------------------------------
Taxonomy Name | Massage Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------