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General NPI Number Information
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NPI Number | 1609752088
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Entity Type | Individual
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Provider Name | JILL R LEWIS CORTAZAR LICENSED MASSAGE THE
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Gender | Female
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Dates
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Enumeration Date | 08/12/2025
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Last Update Date | 08/12/2025
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Provider Practice Location Address
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Address Line | 559 ATLANTIC AVE
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City | EAST ROCKAWAY
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State | NY
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Zip | 11518-1530
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Country | US
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Telephone | 516-593-8333
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Fax |
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Provider Business Mailing Address
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Address Line | 38 VINCENT PL
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City | LYNBROOK
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State | NY
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Zip | 11563-3755
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Country | US
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Telephone | 917-566-9048
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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 | 011444
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License Number State | NY
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