Provider Demographics
NPI:1134240229
Name:WOOLFSON, DANA (LMT)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:WOOLFSON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1334 BEECH ST
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11509-1613
Mailing Address - Country:US
Mailing Address - Phone:516-241-3071
Mailing Address - Fax:
Practice Address - Street 1:1334 BEECH ST
Practice Address - Street 2:
Practice Address - City:ATLANTIC BEACH
Practice Address - State:NY
Practice Address - Zip Code:11509-1613
Practice Address - Country:US
Practice Address - Phone:516-241-3071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006693-1225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist