Active NPI
Dylan James Corona, LMT, CPT, CES
- Massage Therapist
- Manalapan, NJ
National Provider Identifier
1093386252
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 18KT01235700
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 18KT01235700 | NJ | MD | Massage 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.