MOUNTAINSIDE DIVERSIFIED NPI 1689251712

NPI Information

MOUNTAINSIDE DIVERSIFIED is a massage therapist in Staten Island, NY. The provider is an individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. MOUNTAINSIDE DIVERSIFIED NPI is 1689251712. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1324 FOREST AVE
STATEN ISLAND, NY
ZIP 10302-044
Phone: (877) 480-8038

The provider's authorized official is Heather Miller .
The authorized official title is Partner/manager and has the following contact phone number (877) 480-8038.

The enumeration date for this NPI number is 3/25/2021 and was last updated on 3/25/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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