Provider Demographics
NPI:1629832464
Name:TOUCHED BY A ROSE
Entity Type:Organization
Organization Name:TOUCHED BY A ROSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AUDREY
Authorized Official - Middle Name:
Authorized Official - Last Name:DONALDSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:516-545-0056
Mailing Address - Street 1:12 RUSSELL ST
Mailing Address - Street 2:
Mailing Address - City:LYNBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11563-1145
Mailing Address - Country:US
Mailing Address - Phone:516-545-0056
Mailing Address - Fax:518-585-4404
Practice Address - Street 1:15 ATLANTIC AVE STE 305
Practice Address - Street 2:
Practice Address - City:LYNBROOK
Practice Address - State:NY
Practice Address - Zip Code:11563-3051
Practice Address - Country:US
Practice Address - Phone:516-545-0056
Practice Address - Fax:518-585-4404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty