1285167171 NPI number — BODY EASE THERAPY LLP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285167171 NPI number — BODY EASE THERAPY LLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BODY EASE THERAPY LLP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1285167171
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/06/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
21 COUNTRY GATES DR
Provider Second Line Business Mailing Address:
WILMINGTON DE 19810
Provider Business Mailing Address City Name:
WILMINGTON
Provider Business Mailing Address State Name:
DE
Provider Business Mailing Address Postal Code:
19810-2361
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-314-0780
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
105 LOUVIERS DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWARK
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19711-4163
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-314-0780
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/06/2017

Additional Information

Authorized Official

Authorized Official Last Name:
GOTTESMAN
Authorized Official First Name:
RACHEL
Authorized Official Middle Name:
Authorized Official Title or Position:
OCCUPATIONAL THERAPIST
Authorized Official Telephone Number:
610-314-0780

Provider Taxonomy Codes

  • Taxonomy code: 225700000X , with the licence number:  MT-0004458 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225X00000X , with the licence number: U1-0000948 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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