Shimon Yevdayev, LMT
Individual provider Active NPI Reflexologist · Brooklyn, NY
NPI 1124478342 · NPPES record last updated May 15, 2025
Key facts
- NPI
- 1124478342
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Reflexologist 173C00000X
- License
- 028836 (NY)
- Practice address
- 1812 Quentin Rd FL 1
Brooklyn, NY 11229-1367 - Phone
- (347) 277-8923
- NPI assigned
- Jun 18, 2016
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 028836 | NY | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | |||
| Reflexologist | 173C00000X | 028836 | NY | Yes |
Addresses
Primary practice location
1812 Quentin Rd FL 1
Brooklyn, NY 11229-1367
Mailing address
2775 E 16TH St Apt 5H
Brooklyn, NY 11235-4045
Phone (917) 216-6961
Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 15, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.