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General NPI Number Information
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NPI Number | 1700602984
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Entity Type | Organization
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Legal Business Name | ESSENTIAL MASSAGE H & W, LLC
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Dates
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Enumeration Date | 12/03/2024
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Last Update Date | 12/03/2024
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Provider Practice Location Address
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Address Line | 34 BAY ST STE 203
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City | SAG HARBOR
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State | NY
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Zip | 11963-3104
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Country | US
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Telephone | 631-899-3216
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Fax |
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Provider Business Mailing Address
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Address Line | 16 BIRCH ST
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City | SAG HARBOR
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State | NY
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Zip | 11963-1722
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Country | US
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Telephone | 631-833-1313
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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 | STEPHANIE JOANNE ESPOSITO
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Credential | MT
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Telephone | 631-833-1313
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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 |
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License Number State |
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