Provider Demographics
NPI:1225629124
Name:SEARS, MARGUERITE A (LMT)
Entity Type:Individual
Prefix:MRS
First Name:MARGUERITE
Middle Name:A
Last Name:SEARS
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 1:9 GREGORY WAY
Mailing Address - Street 2:
Mailing Address - City:CALVERTON
Mailing Address - State:NY
Mailing Address - Zip Code:11933-1137
Mailing Address - Country:US
Mailing Address - Phone:631-369-9218
Mailing Address - Fax:631-369-0988
Practice Address - Street 1:9 GREGORY WAY
Practice Address - Street 2:
Practice Address - City:CALVERTON
Practice Address - State:NY
Practice Address - Zip Code:11933-1137
Practice Address - Country:US
Practice Address - Phone:631-369-9218
Practice Address - Fax:631-369-0988
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-02
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008803225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist