MEDICARE: SASIGHAN PRASERTSRI

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
1	225700000X	Massage Therapist	023021	NY
2	225700000X	Massage Therapist

General Provider Information

NPI Number	:	1437780814
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SASIGHAN PRASERTSRI

Provider Business Mailing Address
First Line	:	767 LEXINGTON AVE RM 304
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10065-8553
Country	:	US
Telephone Number	:	212-759-6618
Fax Number	:

Provider Business Practice Location Address
First Line	:	767 LEXINGTON AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10065-8553
Country	:	US
Telephone Number	:	212-759-6618
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/04/2020
Last Update Date	:	02/04/2020

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Directions to “ SASIGHAN PRASERTSRI ” Practice Location

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