MEDICARE: MARCIE J LEON-DOYLE

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	012324-01	NY

General Provider Information

NPI Number	:	1780374546
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCIE J LEON-DOYLE

Provider Business Mailing Address
First Line	:	67 S MIDLAND AVE
Second Line	:
City	:	NYACK
State	:	NY
Zip	:	10960-2436
Country	:	US
Telephone Number	:	845-598-2040
Fax Number	:

Provider Business Practice Location Address
First Line	:	16 SQUADRON BLVD STE 102
Second Line	:
City	:	NEW CITY
State	:	NY
Zip	:	10956-5268
Country	:	US
Telephone Number	:	845-598-2040
Fax Number	:

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

Provider Enumeration Date	:	05/15/2023
Last Update Date	:	05/15/2023

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