Provider Demographics
NPI:1144473141
Name:ONE MAGIC TOUCH
Entity type:Organization
Organization Name:ONE MAGIC TOUCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANATOLI
Authorized Official - Middle Name:
Authorized Official - Last Name:YOSHOVAYEV
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:917-977-0096
Mailing Address - Street 1:8502 139TH ST
Mailing Address - Street 2:3E
Mailing Address - City:BRIARWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11435-2645
Mailing Address - Country:US
Mailing Address - Phone:917-977-0096
Mailing Address - Fax:
Practice Address - Street 1:8502 139TH ST
Practice Address - Street 2:3E
Practice Address - City:BRIARWOOD
Practice Address - State:NY
Practice Address - Zip Code:11435-2645
Practice Address - Country:US
Practice Address - Phone:917-977-0096
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-04
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029274225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY029274OtherLICENSE NUMBER