Provider Demographics
NPI:1467275115
Name:KNEADING TIME, LLC
Entity type:Organization
Organization Name:KNEADING TIME, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAMARIS
Authorized Official - Middle Name:
Authorized Official - Last Name:SUMMO
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:845-863-3009
Mailing Address - Street 1:30 HANNAH LN
Mailing Address - Street 2:
Mailing Address - City:NEW WINDSOR
Mailing Address - State:NY
Mailing Address - Zip Code:12553-7287
Mailing Address - Country:US
Mailing Address - Phone:917-468-4979
Mailing Address - Fax:
Practice Address - Street 1:45 ACADEMY AVE
Practice Address - Street 2:
Practice Address - City:CORNWALL ON HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12520-1340
Practice Address - Country:US
Practice Address - Phone:845-863-3009
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-01
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty