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General NPI Number Information
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NPI Number | 1730750373
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Entity Type | Organization
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Legal Business Name | BLUE HARBOR HEALING LLC
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Dates
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Enumeration Date | 07/06/2021
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Last Update Date | 07/06/2021
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Provider Practice Location Address
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Address Line | 215 GLEN COVE AVE UNIT C
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City | SEA CLIFF
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State | NY
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Zip | 11579-1457
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Country | US
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Telephone | 516-376-1227
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Fax |
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Provider Business Mailing Address
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Address Line | 141 GREAT NECK RD APT 3B
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City | GREAT NECK
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State | NY
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Zip | 11021-3320
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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 | LMT
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Name | HOPE NABAVIAN
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Credential |
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Telephone | 516-376-1227
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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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