Renee' Amico-Taback, LMT

Individual provider Active NPI Massage Therapist · Westbury, NY

NPI 1235447608 · NPPES record last updated Sep 20, 2010

Key facts

NPI
1235447608
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
0045191 (NY)
Practice address
49 Mead LN
Westbury, NY 11590-6303
Phone
(516) 997-5172
Fax
(516) 997-5172
NPI assigned
Sep 20, 2010
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0045191NYMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 0045191 NY Yes

Addresses

Primary practice location

49 Mead LN
Westbury, NY 11590-6303

Mailing address

49 Mead LN
Westbury, NY 11590-6303
Phone (516) 997-5172

Other providers in Westbury, NY

All providers in Westbury, NY · Massage Therapist in New York

Sources for this page

Verify at the official NPI Registry.