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General NPI Number Information
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NPI Number | 1851778112
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Entity Type | Organization
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Legal Business Name | HANUSA MASSAGE THERAPY OF THE HAMPTONS
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Dates
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Enumeration Date | 05/06/2015
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Last Update Date | 05/06/2015
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Provider Practice Location Address
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Address Line | 52A OLD COUNTRY RD
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City | WESTHAMPTON
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State | NY
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Zip | 11977-1218
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Country | US
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Telephone | 631-872-4921
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Fax |
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Provider Business Mailing Address
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Address Line | 52A OLD COUNTRY RD
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City | WESTHAMPTON
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State | NY
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Zip | 11977-1218
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Country | US
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Telephone | 631-872-4921
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Fax |
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Authorized Official
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Title or Position | LMT
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Name | MARLENE HANUSA
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Credential | LICENSED MASSAGE THE
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Telephone | 631-872-4921
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | 026157
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 332000000X
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Taxonomy Name | Military/U.S. Coast Guard Pharmacy
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License Number | 026157
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 320700000X
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Taxonomy Name | Physical Disabilities Residential Treatment Facility
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License Number | 026157
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License Number State | NY
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