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General NPI Number Information
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NPI Number | 1770351926
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Entity Type | Organization
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Legal Business Name | FUNX LLC
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Dates
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Enumeration Date | 12/18/2023
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Last Update Date | 12/18/2023
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Provider Practice Location Address
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Address Line | 55 MAIN ST
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City | SAYVILLE
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State | NY
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Zip | 11782-2501
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Country | US
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Telephone | 631-834-3759
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Fax |
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Provider Business Mailing Address
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Address Line | 55 MAIN ST
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City | SAYVILLE
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State | NY
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Zip | 11782-2501
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Country | US
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Telephone | 631-834-3759
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Fax |
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | HUNTER LEIFER
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Credential |
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Telephone | 631-834-3759
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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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