Provider Demographics
NPI:1487371720
Name:LSM MASSAGE AND LYMPHATICS LLC
Entity type:Organization
Organization Name:LSM MASSAGE AND LYMPHATICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MAYERNIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-398-7771
Mailing Address - Street 1:910 ASHLAND ST
Mailing Address - Street 2:
Mailing Address - City:VALLEY COTTAGE
Mailing Address - State:NY
Mailing Address - Zip Code:10989-2613
Mailing Address - Country:US
Mailing Address - Phone:845-398-7771
Mailing Address - Fax:
Practice Address - Street 1:910 ASHLAND ST
Practice Address - Street 2:
Practice Address - City:VALLEY COTTAGE
Practice Address - State:NY
Practice Address - Zip Code:10989-2613
Practice Address - Country:US
Practice Address - Phone:845-398-7771
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-27
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation