Provider Demographics
NPI:1023295433
Name:MEDICAL MASSAGE OF MANHATTAN
Entity type:Organization
Organization Name:MEDICAL MASSAGE OF MANHATTAN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-348-0929
Mailing Address - Street 1:2 W 120TH ST
Mailing Address - Street 2:SUITE 7-O
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-6302
Mailing Address - Country:US
Mailing Address - Phone:212-348-0929
Mailing Address - Fax:
Practice Address - Street 1:2 W 120TH ST
Practice Address - Street 2:SUITE 7-O
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-6302
Practice Address - Country:US
Practice Address - Phone:212-348-0929
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-28
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012178-1261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty