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General NPI Number Information
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NPI Number | 1700039856
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Entity Type | Organization
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Legal Business Name | MIDDAY MASSAGE
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Dates
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Enumeration Date | 11/01/2008
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Last Update Date | 10/27/2009
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Provider Practice Location Address
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Address Line | 1739 DEER PARK AVE
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City | DEER PARK
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State | NY
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Zip | 11729-5206
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Country | US
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Telephone | 631-940-6095
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Fax |
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Provider Business Mailing Address
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Address Line | 119 CEDAR RD
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City | AMITYVILLE
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State | NY
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Zip | 11701-1326
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Country | US
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Telephone | 631-940-6095
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Fax |
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Authorized Official
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Title or Position | MASSAGE THERAPIST
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Name | MS. RUTH PIERRE
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Credential | MASSAGE THERAPY
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Telephone | 631-940-6095
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 173C00000X
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Taxonomy Name | Reflexologist
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License Number | 021951
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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