1346571080 NPI number — HAN'S THERAPEUTIC MASSAGE, P.C.

Table of content: (NPI 1346571080)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346571080 NPI number — HAN'S THERAPEUTIC MASSAGE, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HAN'S THERAPEUTIC MASSAGE, P.C.
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:
1346571080
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/20/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
153-01 NORTHERN BLVD
Provider Second Line Business Mailing Address:
SUITE 2G
Provider Business Mailing Address City Name:
FLUSHING
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11354
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-888-1641
Provider Business Mailing Address Fax Number:
718-888-2514

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
153-01 NORTHERN BLVD
Provider Second Line Business Practice Location Address:
SUITE 2G
Provider Business Practice Location Address City Name:
FLUSHING
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11354
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-888-1641
Provider Business Practice Location Address Fax Number:
718-888-2514
Provider Enumeration Date:
01/20/2010

Additional Information

Authorized Official

Authorized Official Last Name:
HAN
Authorized Official First Name:
KAREN
Authorized Official Middle Name:
J.
Authorized Official Title or Position:
DIRECT OWNER
Authorized Official Telephone Number:
718-888-1641

Provider Taxonomy Codes

  • Taxonomy code: 225700000X , with the licence number:  021488 , 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)

  • Identifier: 718082 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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