Provider Demographics
NPI:1891823936
Name:SPA BELLE MEADE PPLC
Entity type:Organization
Organization Name:SPA BELLE MEADE PPLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HILTON
Authorized Official - Middle Name:C
Authorized Official - Last Name:ADLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-751-4400
Mailing Address - Street 1:179 N BELLE MEAD RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:EAST SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-3456
Mailing Address - Country:US
Mailing Address - Phone:631-751-2693
Mailing Address - Fax:631-751-4428
Practice Address - Street 1:179 N BELLE MEAD RD
Practice Address - Street 2:SUITE 2
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-3456
Practice Address - Country:US
Practice Address - Phone:631-751-2693
Practice Address - Fax:631-751-4428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty