Provider Demographics
NPI:1225362262
Name:BAYERRI-ALBESA, CARLOS (LAC, LMT)
Entity type:Individual
Prefix:MR
First Name:CARLOS
Middle Name:
Last Name:BAYERRI-ALBESA
Suffix:
Gender:M
Credentials:LAC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 OVERLOOK PL # 2
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-6311
Mailing Address - Country:US
Mailing Address - Phone:917-755-8950
Mailing Address - Fax:
Practice Address - Street 1:699 SACKETT ST
Practice Address - Street 2:GROUNDFLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-4561
Practice Address - Country:US
Practice Address - Phone:917-755-8950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-23
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023595-1225700000X
NY004185171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No171100000XOther Service ProvidersAcupuncturist