Provider Demographics
NPI:1326612896
Name:ATLANTIS HEALTH NETWORK, LLC
Entity Type:Organization
Organization Name:ATLANTIS HEALTH NETWORK, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:VARIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-744-3661
Mailing Address - Street 1:27 N COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:SHOREHAM
Mailing Address - State:NY
Mailing Address - Zip Code:11786-1342
Mailing Address - Country:US
Mailing Address - Phone:631-744-3661
Mailing Address - Fax:631-929-8292
Practice Address - Street 1:27 N COUNTRY RD
Practice Address - Street 2:
Practice Address - City:SHOREHAM
Practice Address - State:NY
Practice Address - Zip Code:11786-1342
Practice Address - Country:US
Practice Address - Phone:631-744-3661
Practice Address - Fax:631-929-8292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-18
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty