MR. MAXWELL ENNIST LMT
NPI 1215535505
Massage Therapist in Bronx, NY
Active since October 09, 2020
About Mr. Maxwell Ennist Lmt NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. MAXWELL ENNIST LMT (NPI 1215535505) is an individual massage therapist in Bronx, New York, licensed in New York (0308231) and active in the NPI registry since October 2020.
NPPES Registry Identity
NPI1215535505
Entity TypeIndividualMale
Primary Taxonomy225700000X
Provider Legal NameMR. MAXWELL ENNISTCredential: LMT
Location Address210 BEDFORD PARK BLVDBronx, NY 10467
Mailing Address3504 Rochambeau Ave Apt 1jBronx, NY 10467-1376 · (914) 315-9088
Phone(914) 315-9088
Sole ProprietorYes
Enumeration DateOctober 9, 2020
NPPES CertifiedSeptember 10, 2020
✔ NPI 1215535505 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225700000X
License✔ Licensed in NY · 0308231
Definition
An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.
210 BEDFORD PARK BLVD, Bronx, NY 10467
Group Practice 1
Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1215535505, enumerated as an "individual" on October 09, 2020.
The provider is located at 210 BEDFORD PARK BLVD BRONX, NY 10467 and the phone number is (914) 315-9088.
Massage Therapist with taxonomy code 225700000X.
