Spa Boutique 2Go LLC

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

023837 Issued in NY

Legal business name

SPA BOUTIQUE 2GO LLC

Practice address

115 W 128TH St
New York, NY 10027-3012

Phone

(646) 626-0981

NPI assigned

Oct 17, 2013

Organization subpart

No

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

Authorized official

Name

Shirley Garner, LMT

Title

Owner

Phone

(646) 626-0981

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1381968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381968000000",
    "number": "1750719316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16832 127TH AVE",
            "address_2": "12D",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114343156",
            "telephone_number": "646-626-0981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 W 128TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100273012",
            "telephone_number": "646-626-0981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPA BOUTIQUE 2GO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-17",
        "last_updated": "2013-10-17",
        "status": "A",
        "authorized_official_last_name": "GARNER",
        "authorized_official_first_name": "SHIRLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "646-626-0981",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "023837",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN SPECIALTY HEALTH",
            "identifier": "1149130",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Massage Therapist in New York, NY
• Providers in New York, 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 Oct 17, 2013; 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.