Provider Demographics
NPI:1043967409
Name:YAGI, KAORI (LMT)
Entity Type:Individual
Prefix:
First Name:KAORI
Middle Name:
Last Name:YAGI
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 W 26TH ST RM 701
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-6804
Mailing Address - Country:US
Mailing Address - Phone:917-600-9419
Mailing Address - Fax:
Practice Address - Street 1:122 W 26TH ST RM 701
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-6804
Practice Address - Country:US
Practice Address - Phone:917-600-9419
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-06
Last Update Date:2022-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027709225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist