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General NPI Number Information
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NPI Number | 1871474411
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Entity Type | Organization
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Legal Business Name | LILA HOLISTICS INC.
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Dates
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Enumeration Date | 09/10/2025
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Last Update Date | 09/10/2025
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Provider Practice Location Address
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Address Line | 2228 MONTAUK HWY
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City | BRIDGEHAMPTON
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State | NY
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Zip | 11932-4001
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Country | US
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Telephone | 631-500-5452
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Fax |
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Provider Business Mailing Address
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Address Line | 418 BROADWAY # 8839
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City | ALBANY
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State | NY
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Zip | 12207-2922
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Country | US
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Telephone | 631-500-5452
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DORI FORTUNATO
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Credential | DAOM LIC. AC LMT
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Telephone | 631-500-5452
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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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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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