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General NPI Number Information
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NPI Number | 1245557800
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Entity Type | Individual
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Provider Name | MIGUEL ANGEL SIERRA LMT
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Gender | Male
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Dates
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Enumeration Date | 04/22/2010
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Last Update Date | 10/07/2016
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Provider Practice Location Address
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Address Line | 32 UNION SQUARE EAST SUITE 411
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City | NEW YORK
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State | NY
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Zip | 10003-4935
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Country | US
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Telephone | 917-595-7534
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Fax |
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Provider Business Mailing Address
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Address Line | 128 SEAMAN AVE 2C
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City | NEW YORK
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State | NY
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Zip | 10034-1967
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Country | US
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Telephone | 917-595-7534
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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 | 27023492
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License Number State | NY
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