MEDICARE: TZIPPORAH GOLDSMITH

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	032492	NY

General Provider Information

NPI Number	:	1619551975
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TZIPPORAH GOLDSMITH

Provider Business Mailing Address
First Line	:	719 WOOLLEY AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-4240
Country	:	US
Telephone Number	:	347-552-2119
Fax Number	:

Provider Business Practice Location Address
First Line	:	719 WOOLLEY AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-4240
Country	:	US
Telephone Number	:	347-552-2119
Fax Number	:

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

Provider Enumeration Date	:	05/11/2021
Last Update Date	:	05/11/2021

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Directions to “ TZIPPORAH GOLDSMITH ” Practice Location

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