GREEN PASTURES STILL WATERS, LLC (NPI# 1467090803) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467090803 |
| Entity Type | Organization |
| Organization Name | GREEN PASTURES STILL WATERS, LLC |
| Practice Address |
1413 Hertel Ave Ste 1 Buffalo NY 14216-2831 |
| Mailing Address |
259 Greenhaven Ter Tonawanda NY 14150-5551 |
| Practice Telephone | 7169222772 |
| Mailing Telephone | 7164350020 |
| Enumeration Date | 2019-12-17 |
| Last Update Date | 2019-12-17 |
| Authorized Official Name | LAURA LOUISE ZIMBERG (OWNER/LMT) |
| Authorized Official Telephone | 7164350020 |
| Authorized Official Credential | LMT |
| Is Organization Subpart | Y |
| Parent Organization Name | GREEN PASTURES STILL WATERS, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Other Name | Type Code |
|---|---|
| Green Pastures Still Waters Massage Therapy & Spa | Former Legal Business Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2720 Eggert Rd, Tonawanda, NY 141508734 | 7164350020 |
| Street Address |
1413 HERTEL AVE STE 1 |
| City | BUFFALO |
| State | NY |
| Zip Code | 14216-2831 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740752054 | Melanie Ivette Gonzalez | Occupational Therapist | 81 Rachel Vincent Way, Buffalo, NY 14216 | 2018-12-27 |
| 1245650308 | Maria Orellana-matta | Family Medicine | 900 Hertel Avenue, Buffalo, NY 14216 | 2014-04-16 |
| 1174823298 | Kostace Leslie Kyser | Dental Hygienist | 78 Commonwealth, Buffalo, NY 14216 | 2010-10-22 |
| 1205150737 | Barbara Jane Madison | Pharmacist | 1388 Hertel Ave, Buffalo, NY 14216 | 2010-03-26 |
| 1487894317 | Melissa Ryan Trillo | Speech-Language Pathologist | 780 Parkside Ave, Buffalo, NY 14216 | 2009-03-05 |
| 1003033010 | Dan W Rajca | Pharmacist | 1001 Hertel Avenue, Buffalo, NY 14216 | 2007-04-19 |
| 1629294806 | Nikita Chandrakant Dave | Physical Medicine & Rehabilitation | 699 Hertel Ave., Industrial Medicine Office, Buffalo, NY 14216 | 2007-04-17 |
| 1437260692 | Ruth Theresa Black | Social Worker | 29 Tennyson Ave, Buffalo, NY 14216 | 2006-08-31 |
| 1033229604 | Promed Inc | Durable Medical Equipment & Medical Supplies | 350 Hinman Ave, Buffalo, NY 14216 | 2006-08-30 |
| 1457361719 | Sylvia Marzullo | Physical Therapist | 2625 Delaware Ave, Buffalo, NY 14216 | 2006-08-09 |
| Find all providers in zip 14216 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407491392 | Micheal J Beck | Massage Therapist | 174 Lexington Ave Uppr, Buffalo, NY 14222-1810 | 2019-11-14 |
| 1235782822 | Matthew C Overfield | Massage Therapist | 3435 Harlem Rd Ste 7, Buffalo, NY 14225-2021 | 2019-07-22 |
| 1487120234 | Lakieta L Smith | Massage Therapist | 820 Elmwood Ave, 5, Buffalo, NY 14222 | 2018-10-19 |
| 1063998664 | Angela Smith | Massage Therapist | 700 Main St Fl 1, Buffalo, NY 14202-1924 | 2018-07-17 |
| 1073003737 | Angela Jessie | Massage Therapist | 4525 Main St, Buffalo, NY 14226-3809 | 2018-05-17 |
| 1356876973 | Kaaremah Ali | Massage Therapist | 33 Wadsworth St, Buffalo, NY 14201-1305 | 2017-04-21 |
| 1073968970 | Stephanie Szpila | Massage Therapist | 31 Shenandoah Rd, Buffalo, NY 14220-2417 | 2016-04-28 |
| 1306244678 | Stacey A Sutton | Massage Therapist | 147 Hazelwood Ave, Buffalo, NY 14215-3516 | 2014-12-18 |
| 1942616230 | Deidre Medina | Massage Therapist | 120 Eller Ave, Buffalo, NY 14211-2115 | 2014-07-07 |
| 1023438629 | Sakina Chenini | Massage Therapist | 49 Lynn St, Buffalo, NY 14218-2047 | 2014-04-22 |
| Find all providers in BUFFALO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.