Provider Demographics
NPI:1245778711
Name:ANAHATA OHM LLC
Entity Type:Organization
Organization Name:ANAHATA OHM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMT/CERTIFIED REFLEXOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JAMIELEE
Authorized Official - Middle Name:
Authorized Official - Last Name:KREUTZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:631-268-8600
Mailing Address - Street 1:PO BOX 414
Mailing Address - Street 2:
Mailing Address - City:MASTIC BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11951-0414
Mailing Address - Country:US
Mailing Address - Phone:631-268-8600
Mailing Address - Fax:
Practice Address - Street 1:179 WILLIAM FLOYD PKWY
Practice Address - Street 2:
Practice Address - City:SHIRLEY
Practice Address - State:NY
Practice Address - Zip Code:11967-3439
Practice Address - Country:US
Practice Address - Phone:631-268-8600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-05
Last Update Date:2017-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY27028770173C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173C00000XOther Service ProvidersReflexologistGroup - Single Specialty