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General NPI Number Information
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NPI Number | 1215765474
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Entity Type | Individual
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Provider Name | ARIELLA L POPICK
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Gender | Female
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Dates
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Enumeration Date | 07/22/2024
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Last Update Date | 07/22/2024
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Provider Practice Location Address
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Address Line | 97 NEW DORP LN STE D
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City | STATEN ISLAND
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State | NY
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Zip | 10306-2364
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Country | US
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Telephone | 646-389-0325
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Fax |
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Provider Business Mailing Address
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Address Line | 700 VICTORY BLVD STE 14A
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City | STATEN ISLAND
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State | NY
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Zip | 10301-3509
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Country | US
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Telephone | 917-443-6494
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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 | 030777
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License Number State | NY
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