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General NPI Number Information
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NPI Number | 1427604206
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Entity Type | Organization
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Legal Business Name | EMBRACE YOUR ENERGY, LLC
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Dates
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Enumeration Date | 08/16/2019
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Last Update Date | 08/16/2019
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Provider Practice Location Address
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Address Line | 300 WINCORAM WAY
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City | CORAM
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State | NY
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Zip | 11727
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Country | US
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Telephone | 631-741-5182
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Fax |
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Provider Business Mailing Address
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Address Line | 605 DOLPHIN LN
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City | HOLBROOK
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State | NY
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Zip | 11741-6205
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Country | US
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Telephone | 631-902-0178
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | SHARON INFANTE
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Credential |
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Telephone | 631-741-5182
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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