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General NPI Number Information
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NPI Number | 1881169878
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Entity Type | Individual
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Provider Name | TANIA V MARTELL SOLIZ LMT
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Gender | Female
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Dates
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Enumeration Date | 10/05/2018
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Last Update Date | 10/05/2018
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Provider Practice Location Address
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Address Line | 3749 91ST ST
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-7927
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Country | US
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Telephone | 718-775-8990
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Fax |
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Provider Business Mailing Address
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Address Line | 9134 108TH ST
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City | RICHMOND HILL
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State | NY
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Zip | 11418-2231
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Country | US
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Telephone | 718-662-3970
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 031293
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License Number State | NY
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