Provider Demographics
NPI:1699533448
Name:THE BODY BAR NEW YORK LLC
Entity type:Organization
Organization Name:THE BODY BAR NEW YORK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCHWALD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LMT
Authorized Official - Phone:716-249-2118
Mailing Address - Street 1:40 GARDENVILLE PKWY STE 221
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-1399
Mailing Address - Country:US
Mailing Address - Phone:716-249-2118
Mailing Address - Fax:
Practice Address - Street 1:40 GARDENVILLE PKWY STE 221
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-1399
Practice Address - Country:US
Practice Address - Phone:716-249-2118
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-07
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty