Provider Demographics
NPI:1053714980
Name:MEISEL, ADINA (LMT)
Entity type:Individual
Prefix:MS
First Name:ADINA
Middle Name:
Last Name:MEISEL
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 1:6625 103RD ST
Mailing Address - Street 2:APT 6H
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-2001
Mailing Address - Country:US
Mailing Address - Phone:917-697-0004
Mailing Address - Fax:
Practice Address - Street 1:6625 103RD ST
Practice Address - Street 2:APT 6H
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-2001
Practice Address - Country:US
Practice Address - Phone:917-697-0004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-07
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY27 027989225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist