Provider Demographics
NPI:1053116269
Name:TARVER, HI-QUAVIA S (LMT)
Entity type:Individual
Prefix:
First Name:HI-QUAVIA
Middle Name:S
Last Name:TARVER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2751 SAMPSON AVE APT 1C
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10465-2930
Mailing Address - Country:US
Mailing Address - Phone:518-698-3630
Mailing Address - Fax:
Practice Address - Street 1:2751 SAMPSON AVE APT 1C
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10465-2930
Practice Address - Country:US
Practice Address - Phone:518-698-3630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-13
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033662-01225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist