MEDICARE: ESSENCE OF BEAUTY MED SPA

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

General Provider Information

NPI Number	:	1912864331
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ESSENCE OF BEAUTY MED SPA

Provider Business Mailing Address
First Line	:	3850 BELL BLVD
Second Line	:	SUITE A2
City	:	BAYSIDE
State	:	NY
Zip	:	11361
Country	:	US
Telephone Number	:	718-589-4541
Fax Number	:	718-893-8511

Provider Business Practice Location Address
First Line	:	3850 BELL BLVD
Second Line	:	SUITE A2
City	:	BAYSIDE
State	:	NY
Zip	:	11361
Country	:	US
Telephone Number	:	718-589-4541
Fax Number	:	718-893-8511

Authorized Official
Title or Position	:	OWNER
Name	:	RACQUEL PETERS
Credential	:
Telephone Number	:	718-589-4541

Provider Enumeration Date	:	01/07/2026
Last Update Date	:	01/07/2026

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Directions to “ESSENCE OF BEAUTY MED SPA ” Practice Location

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