Provider Demographics
NPI:1306009154
Name:SIMILIO, RAQUEL (LAC, LMT, CLT)
Entity Type:Individual
Prefix:MS
First Name:RAQUEL
Middle Name:
Last Name:SIMILIO
Suffix:
Gender:F
Credentials:LAC, LMT, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4410 BROADWAY APT 4H
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10040-4084
Mailing Address - Country:US
Mailing Address - Phone:646-325-6913
Mailing Address - Fax:
Practice Address - Street 1:161 FT WASHINGTN AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3729
Practice Address - Country:US
Practice Address - Phone:212-305-8029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-02
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019508-1225700000X
NY004960-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist