Provider Demographics
NPI:1710047030
Name:PSOAS MASSAGE THERAPY OFFICES, P.C.
Entity Type:Organization
Organization Name:PSOAS MASSAGE THERAPY OFFICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:917-304-2512
Mailing Address - Street 1:400 CHAMBERS ST
Mailing Address - Street 2:10Y
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10282-1003
Mailing Address - Country:US
Mailing Address - Phone:917-304-2512
Mailing Address - Fax:212-684-1521
Practice Address - Street 1:32 E 37TH ST
Practice Address - Street 2:GROUND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-3008
Practice Address - Country:US
Practice Address - Phone:917-304-2512
Practice Address - Fax:212-684-1521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009070225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty