Provider Demographics
NPI:1346814324
Name:TOTALLY YOU SPA INC
Entity Type:Organization
Organization Name:TOTALLY YOU SPA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAYON
Authorized Official - Middle Name:S
Authorized Official - Last Name:PINNOCK
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:212-301-7619
Mailing Address - Street 1:PO BOX 222059
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11022-2059
Mailing Address - Country:US
Mailing Address - Phone:212-301-7619
Mailing Address - Fax:
Practice Address - Street 1:310 E SHORE RD STE 301
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11023-2432
Practice Address - Country:US
Practice Address - Phone:212-301-7619
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-14
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty