MEDICARE: JASMIN CARRION

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	020267	NY

General Provider Information

NPI Number	:	1902932064
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASMIN CARRION

Provider Business Mailing Address
First Line	:	630 PUGSLEY AVE APT 3E
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10473-2149
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	630 PUGSLEY AVE APT 3E
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10473-2149
Country	:	US
Telephone Number	:	845-300-9088
Fax Number	:

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

Provider Enumeration Date	:	02/25/2007
Last Update Date	:	07/08/2007

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Directions to “ JASMIN CARRION ” Practice Location

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