Provider Demographics
NPI:1548685639
Name:SEA OF TRANQUILITY MASSAGE CORPORATION
Entity type:Organization
Organization Name:SEA OF TRANQUILITY MASSAGE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RENI
Authorized Official - Middle Name:
Authorized Official - Last Name:TANOUE-BROMBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:516-497-1991
Mailing Address - Street 1:1570 GRAND AVE
Mailing Address - Street 2:APT. 6
Mailing Address - City:NORTH BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-1850
Mailing Address - Country:US
Mailing Address - Phone:516-497-1991
Mailing Address - Fax:
Practice Address - Street 1:1570 GRAND AVE
Practice Address - Street 2:APT. 6
Practice Address - City:NORTH BALDWIN
Practice Address - State:NY
Practice Address - Zip Code:11510-1850
Practice Address - Country:US
Practice Address - Phone:516-497-1991
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-26
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty