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NPI Code Detail

MEDICARE: SUSANNA KRALL LMT

MEDICARE:   SUSANNA  KRALL  LMT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage Therapist032940NY

General Provider Information

NPI Number : 1215774039
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSANNA KRALL LMT
Provider Business Mailing Address
First Line : 490 NEW YORK AVE APT 3B
Second Line :
City : BROOKLYN
State : NY
Zip : 11225-4276
Country : US
Telephone Number : 240-449-9975
Fax Number :
Provider Business Practice Location Address
First Line : 490 NEW YORK AVE APT 3B
Second Line :
City : BROOKLYN
State : NY
Zip : 11225-4276
Country : US
Telephone Number : 240-449-9975
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2024
Last Update Date : 07/09/2024

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Directions to “ SUSANNA KRALL LMT” Practice Location

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