Panacea Wellness Studio LLC

Primary specialty

Massage TherapistTaxonomy code 225700000X

Legal business name

PANACEA WELLNESS STUDIO LLC

Practice address

17 N Country Rd Ste B
Port Jefferson, NY 11777-2271

Phone

(631) 509-4270

Fax

(631) 509-4271

NPI assigned

May 9, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Miss Vanessa Johnathan, LMT

Title

Owner

Phone

(516) 427-0394

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1557360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557360000000",
    "number": "1730745282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 N COUNTRY RD STE B",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772271",
            "telephone_number": "631-509-4270",
            "fax_number": "631-509-4271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 N COUNTRY RD STE B",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772271",
            "telephone_number": "631-509-4270",
            "fax_number": "631-509-4271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PANACEA WELLNESS STUDIO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-09",
        "last_updated": "2019-05-09",
        "status": "A",
        "authorized_official_last_name": "JOHNATHAN",
        "authorized_official_first_name": "VANESSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-427-0394",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Cherian Palathra, D.O.
• Candice Pallotta
• Carl Peter Palmblad, DDS
• Carol Palmieri
• Elizabeth Palmieri, LCSW
• Anthony Pang, MD
• Georgia Papadakis, LCSW
• Irina Papp, RPA-C
• Rachel Olivia Para, DO
• Nicole Parisi, CRNA

• Massage Therapist in Port Jefferson, NY
• Providers in Port Jefferson, NY by specialty
• Massage Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.