Provider Demographics
NPI:1285495184
Name:STRAUS, JAZMINE DAIZY (LMT,DD)
Entity type:Individual
Prefix:
First Name:JAZMINE
Middle Name:DAIZY
Last Name:STRAUS
Suffix:
Gender:F
Credentials:LMT,DD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:398 GRANT ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14213-0900
Mailing Address - Country:US
Mailing Address - Phone:607-621-0326
Mailing Address - Fax:
Practice Address - Street 1:398 GRANT ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14213-0900
Practice Address - Country:US
Practice Address - Phone:607-621-0326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030932-01173C00000X, 202D00000X, 225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty
No173C00000XOther Service ProvidersReflexologist
No202D00000XAllopathic & Osteopathic PhysiciansIntegrative Medicine