Most Relevant Information
Provider Data
| NPI Number: | 1003670860 |
| Provider Name: | BIDUR BISTA |
| Entity Type: | Individual |
| Taxonomy Code: | 225700000X |
| Specialty: | Massage Therapist |
| License Number: | 023464-02 |
Most Important Dates
| Enumeration Date: | 02/12/2024 |
| Last Updated: | 02/12/2024 |
Provider Practice Location
525 W 42ND ST
NEW YORK
NY
100366205
Practice Location Phone/Fax
| Phone: | 2124733689 |
| Fax: |
Provider Mailing Location
525 W 42ND ST
NEW YORK
NY
100366205
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |