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General NPI Number Information
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NPI Number | 1740889419
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Entity Type | Organization
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Legal Business Name | SHINING STAR YOGA AND WELLNESS INC.
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Dates
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Enumeration Date | 10/22/2020
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Last Update Date | 10/22/2020
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Provider Practice Location Address
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Address Line | 33 SAINT MARKS AVE
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City | ROCKVILLE CENTRE
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State | NY
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Zip | 11570-4244
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Country | US
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Telephone | 516-643-4286
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Fax |
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Provider Business Mailing Address
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Address Line | 647 BEACH 68TH ST
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City | ARVERNE
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State | NY
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Zip | 11692-1317
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Country | US
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Telephone | 516-643-4286
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Fax |
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Authorized Official
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Title or Position | HOLISTIC HEALTH PRACTITIONER/OWNER
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Name | MISS YAHHILA YEHUDA YISRAEL
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Credential | HHP
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Telephone | 516-643-4286
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number |
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License Number State |
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