1235416793 NPI number — DAVID BIASOTTI MASSAGE THERAPIST

Table of content: DAVID BIASOTTI MASSAGE THERAPIST (NPI 1235416793)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235416793 NPI number — DAVID BIASOTTI MASSAGE THERAPIST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BIASOTTI
Provider First Name:
DAVID
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MASSAGE THERAPIST
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HANDS
Provider Other First Name:
HEALTHFUL
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MASSAGE THERAPIST
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1235416793
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/12/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
32 BROWN RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WAPPINGERS FALLS
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12590-6018
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-224-1036
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
134 SAWKILL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KINGSTON
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12401-1208
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-331-6233
Provider Business Practice Location Address Fax Number:
845-331-5121
Provider Enumeration Date:
11/12/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225700000X , with the licence number:  025294-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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