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General NPI Number Information
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NPI Number | 1699309435
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Entity Type | Individual
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Provider Name | KAYON PINNOCK LMT
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Gender | Female
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Dates
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Enumeration Date | 03/02/2020
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Last Update Date | 03/02/2020
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Provider Practice Location Address
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Address Line | 1419 5TH AVE
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City | BAY SHORE
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State | NY
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Zip | 11706-4129
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Country | US
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Telephone | 973-336-9035
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 222059
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City | GREAT NECK
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State | NY
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Zip | 11022-2059
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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 |
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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 | 0315491
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License Number State | NY
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