Doctor Name: | MR. JEAN PATRICK ELIE |
NPI Number: | 1063889384 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MT |
License Number: | 028512-1 |
Business Practice Address: | 672 Wellwood Ave Unit 2 Lindenhurst, NY - 117571677 |
Business Phone Number: | 5612252623 |
Business Fax Number: | |
Mailing Address: | 25 Rockwood Ave, MASSAPEQUA |
State: | NY |
Postal Code: | 117584745 |
Phone Number: | 5165873337 |
Fax Number: | |
NPI Enumeration Date: | 08/24/2015 |
NPI Last Update Date: | 08/24/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | 028512-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | 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. |