Individual provider Active NPI

Dylan James Corona, LMT, CPT, CES

  • Massage Therapist
  • Manalapan, NJ
National Provider Identifier
1093386252
Registry record updated Jul 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
18KT01235700 Issued in NJ
Practice address
214 Park Ave
Manalapan, NJ 07726-8372
Phone
(848) 459-3342
NPI assigned
Jul 8, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2021

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 18KT01235700 NJ Primary

Addresses

Primary practice location

214 Park Ave
Manalapan, NJ 07726-8372

Mailing address

229 Long Branch Ave
Long Branch, NJ 07740-7564
Phone (848) 459-3342

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
18KT01235700NJMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1625702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1093386252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 LONG BRANCH AVE",
            "city": "LONG BRANCH",
            "state": "NJ",
            "postal_code": "077407564",
            "telephone_number": "848-459-3342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 PARK AVE",
            "city": "MANALAPAN",
            "state": "NJ",
            "postal_code": "077268372",
            "telephone_number": "848-459-3342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORONA",
        "first_name": "DYLAN",
        "middle_name": "JAMES",
        "credential": "LMT, CPT, CES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-08",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NJ",
            "license": "18KT01235700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manalapan, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2021; 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.