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General NPI Number Information
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NPI Number | 1730402488
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Entity Type | Individual
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Provider Name | CRAIG MILEWITZ LMT
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Gender | Male
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Dates
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Enumeration Date | 03/09/2010
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Last Update Date | 03/09/2010
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Provider Practice Location Address
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Address Line | 500 OLD LIVERPOOL RD
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City | LIVERPOOL
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State | NY
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Zip | 13088-6223
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Country | US
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Telephone | 315-708-4267
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Fax |
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Provider Business Mailing Address
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Address Line | 8301 CARNATION DR
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City | BALDWINSVILLE
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State | NY
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Zip | 13027-9365
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Country | US
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Telephone | 315-708-4267
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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 | 023160
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License Number State | NY
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