1689420796 NPI number — NEFTALI ROSARIO ABREU MASSAGE THERAPIST

Table of content: NEFTALI ROSARIO ABREU MASSAGE THERAPIST (NPI 1689420796)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689420796 NPI number — NEFTALI ROSARIO ABREU MASSAGE THERAPIST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROSARIO ABREU
Provider First Name:
NEFTALI
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MASSAGE THERAPIST
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
IZQUIERDO
Provider Other First Name:
NEFTALI
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:
1689420796
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/29/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3326 PALISADE AVE APT A2
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
UNION CITY
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07087-4732
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
917-864-9604
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7700 RIVER ROAD
Provider Second Line Business Practice Location Address:
THE RECOVERY ROOM
Provider Business Practice Location Address City Name:
NORTH BERGEN
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07047
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
917-864-9604
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/29/2024

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:  18KT01457200 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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