Provider Demographics
NPI:1700114832
Name:TAUSSIG, CAREY BENENSON (LMT)
Entity Type:Individual
Prefix:MRS
First Name:CAREY
Middle Name:BENENSON
Last Name:TAUSSIG
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 1:1751 OLD PECOS TRL
Mailing Address - Street 2:STE. N
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-4706
Mailing Address - Country:US
Mailing Address - Phone:505-989-7490
Mailing Address - Fax:
Practice Address - Street 1:5 MOYA LN
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87508-8869
Practice Address - Country:US
Practice Address - Phone:505-699-7964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-01
Last Update Date:2009-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM5575225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist