Provider Demographics
NPI:1356091508
Name:WEISSMANN, SHARON MAE (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:MAE
Last Name:WEISSMANN
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:741 BELLMORE RD
Mailing Address - Street 2:
Mailing Address - City:N BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-3722
Mailing Address - Country:US
Mailing Address - Phone:516-782-8744
Mailing Address - Fax:
Practice Address - Street 1:741 BELLMORE RD
Practice Address - Street 2:
Practice Address - City:N BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710-3722
Practice Address - Country:US
Practice Address - Phone:516-782-8744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-28
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005255-01225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist