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General NPI Number Information
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NPI Number | 1255044582
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Entity Type | Individual
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Provider Name | BEATRIZ VILLABONA LMT
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Gender | Female
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Dates
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Enumeration Date | 01/02/2023
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Last Update Date | 01/02/2023
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Provider Practice Location Address
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Address Line | 598 BROADWAY FL 12
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City | NEW YORK
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State | NY
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Zip | 10012-3351
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Country | US
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Telephone | 646-831-0549
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Fax |
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Provider Business Mailing Address
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Address Line | 254 ELM ST APT 4
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City | NEWARK
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State | NJ
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Zip | 07105-2649
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Country | US
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Telephone | 917-657-8283
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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 | 01806301
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License Number State | NY
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