Provider Demographics
NPI:1164200788
Name:MASSAGE MASTER ENERGY INC
Entity Type:Organization
Organization Name:MASSAGE MASTER ENERGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MASSAGE THERAPIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BORGESANO
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:516-850-6017
Mailing Address - Street 1:1090 NEW YORK AVE #203
Mailing Address - Street 2:
Mailing Address - City:HUTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746
Mailing Address - Country:US
Mailing Address - Phone:516-850-6017
Mailing Address - Fax:
Practice Address - Street 1:1090 NEW YORK AVE #203
Practice Address - Street 2:
Practice Address - City:HUTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746
Practice Address - Country:US
Practice Address - Phone:516-850-6017
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-15
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty