Individual provider Active NPI

Olga Tabibov

  • Massage Therapist
  • New York, NY
National Provider Identifier
1033726062
Registry record updated Sep 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
03051201 Issued in NY
Practice address
207 E 27TH St Apt PHG
New York, NY 10016-9114
Phone
(917) 821-4288
NPI assigned
Sep 24, 2020
Last updated
Sep 24, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 03051201 NY Primary

Addresses

Primary practice location

207 E 27TH St Apt PHG
New York, NY 10016-9114

Mailing address

207 E 27TH St Apt PHG
New York, NY 10016-9114
Phone (917) 821-4288

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
03051201NYMDMassage Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1600905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600905600000",
    "number": "1033726062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 E 27TH ST APT PHG",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100169114",
            "telephone_number": "917-821-4288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 E 27TH ST APT PHG",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100169114",
            "telephone_number": "917-821-4288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABIBOV",
        "first_name": "OLGA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-24",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "03051201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.