Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 019263 | NY |
NPI | 1013227578 |
---|---|
Provider Name | Mrs. Dara B Warshaw |
First Address | North Babylon, NY 11703-1009 |
Second Address | West Islip, NY 11795-4619 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2010 |
Last Update Date | 18/10/2010 |