Provider Demographics
NPI:1043824162
Name:PRESSLEY, ANDRE X (LAC, LMT)
Entity Type:Individual
Prefix:MR
First Name:ANDRE
Middle Name:X
Last Name:PRESSLEY
Suffix:
Gender:M
Credentials:LAC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 HAUSCH BLVD
Mailing Address - Street 2:
Mailing Address - City:ROOSEVELT
Mailing Address - State:NY
Mailing Address - Zip Code:11575-1533
Mailing Address - Country:US
Mailing Address - Phone:631-855-5198
Mailing Address - Fax:
Practice Address - Street 1:6 SPRUCE PL
Practice Address - Street 2:
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-1104
Practice Address - Country:US
Practice Address - Phone:631-855-5198
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-04
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031981-01225700000X
NY007360171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist