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General NPI Number Information
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NPI Number | 1730046335
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Entity Type | Organization
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Legal Business Name | MEADOWSWEET MASSAGE THERAPY
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Dates
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Enumeration Date | 01/06/2026
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | 1461 LAKELAND AVE UNIT 9
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City | BOHEMIA
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State | NY
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Zip | 11716-2174
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Country | US
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Telephone | 631-672-1616
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Fax |
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Provider Business Mailing Address
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Address Line | 30 LEE AVE
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City | PATCHOGUE
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State | NY
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Zip | 11772-3623
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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 | OWNER
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Name | SUZANNE BOGDANOWICH
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Credential | LMT
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Telephone | 631-672-1616
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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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