Provider Demographics
NPI:1154887198
Name:LUNA MESA DAY SPA INC
Entity type:Organization
Organization Name:LUNA MESA DAY SPA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LUANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:SAUER
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:631-874-4114
Mailing Address - Street 1:225 MONTAUK HWY
Mailing Address - Street 2:SUITE 114
Mailing Address - City:MORICHES
Mailing Address - State:NY
Mailing Address - Zip Code:11955-1425
Mailing Address - Country:US
Mailing Address - Phone:631-874-4114
Mailing Address - Fax:631-874-4844
Practice Address - Street 1:225 MONTAUK HWY
Practice Address - Street 2:SUITE 114
Practice Address - City:MORICHES
Practice Address - State:NY
Practice Address - Zip Code:11955-1425
Practice Address - Country:US
Practice Address - Phone:631-874-4114
Practice Address - Fax:631-874-4844
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LUNA MESA DAY SPA INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-02-14
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty