National Provider Identifier
Mark Stephen Banaszak, LMT
Mark Stephen Banaszak, LMT is listed in the NPPES registry with a primary specialty of Massage Therapist in Clarence Center, NY and a listed phone number of (716) 864-9079.
Profile Overview
- NPI
- 1417127218
- Provider Type
- Individual
- Primary Specialty
- Massage Therapist
- Enumeration Date
- March 07, 2008
- Last Updated
- March 07, 2008
Practice Location
- 6321 Balsam Fir Ct
- Clarence Center, NY 14032-9150
Phone: (716) 864-9079
Specialties
- Massage Therapist (225700000X)
Full Record
- NPI
- 1417127218
- Entity Type
- Individual
- Last Name
- Banaszak
- First Name
- Mark
- Middle Name
- Stephen
- Credential
- LMT
- Mailing Street Address
- 6321 Balsam Fir Ct
- Mailing City
- Clarence Center
- Mailing State
- NY
- Mailing ZIP Code
- 14032-9150
- Mailing Country
- US
- Mailing Phone
- (716) 864-9079
- Practice Street Address
- 6321 Balsam Fir Ct
- Practice City
- Clarence Center
- Practice State
- NY
- Practice ZIP Code
- 14032-9150
- Practice Country
- US
- Practice Phone
- (716) 864-9079
- Enumeration Date
- March 07, 2008
- Last Updated
- March 07, 2008
- Sex
- Male
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Massage Therapist (225700000X)