MEDICARE: MS. CHAYA R RAKOFSKY 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
1	225700000X	Massage Therapist	3946	NM

General Provider Information

NPI Number	:	1801023684
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHAYA R RAKOFSKY LMT

Provider Business Mailing Address
First Line	:	HC 69 BOX 7AA
Second Line	:
City	:	SAPELLO
State	:	NM
Zip	:	87745-9600
Country	:	US
Telephone Number	:	505-454-0008
Fax Number	:

Provider Business Practice Location Address
First Line	:	1900 HOT SPRINGS BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NM
Zip	:	87701-3481
Country	:	US
Telephone Number	:	505-454-0008
Fax Number	:

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

Provider Enumeration Date	:	06/18/2009
Last Update Date	:	06/18/2009

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