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General NPI Number Information
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NPI Number | 1679908990
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Entity Type | Organization
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Legal Business Name | OM CRAFT LLC.
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Dates
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Enumeration Date | 09/05/2013
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Last Update Date | 09/05/2013
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Provider Practice Location Address
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Address Line | 7 NORTH VILLAGE AVE
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City | ROCKVILLE CENTRE
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State | NY
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Zip | 11570-4707
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Country | US
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Telephone | 516-619-6421
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Fax |
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Provider Business Mailing Address
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Address Line | 7 N VILLAGE AVE
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City | ROCKVILLE CENTRE
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State | NY
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Zip | 11570-4707
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT, MANAGER, HEAD INSTRUCTOR
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Name | MS. AMANDA DIGIOVANNA
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Credential | E-RYT
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Telephone | 516-619-6421
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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