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General NPI Number Information
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NPI Number | 1205598893
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Entity Type | Individual
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Provider Name | LINDA CHAVEZ LMT
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Gender | Female
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Dates
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Enumeration Date | 10/11/2021
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Last Update Date | 10/11/2021
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Provider Practice Location Address
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Address Line | 700 HORSEBLOCK RD
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City | FARMINGVILLE
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State | NY
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Zip | 11738-1240
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Country | US
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Telephone | 631-804-5888
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Fax |
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Provider Business Mailing Address
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Address Line | 64 BARLEY LN
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City | PATCHOGUE
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State | NY
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Zip | 11772-4177
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Country | US
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Telephone |
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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 | 019401
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 019401
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License Number State | NY
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