Marcos Molina Donnelly
Individual provider Active NPI Massage Therapist · Somers, CT
NPI 1124705124 · NPPES record last updated Jun 30, 2023
Key facts
- NPI
- 1124705124
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 009684 (CT)
- Practice address
- 151 Turnpike Rd
Somers, CT 06071-1740 - Phone
- (860) 406-0939
- NPI assigned
- Jun 30, 2023
- 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 |
|---|---|---|---|
| 009684 | CT | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 009684 | CT | Yes |
Addresses
Primary practice location
151 Turnpike Rd
Somers, CT 06071-1740
Mailing address
151 Turnpike Rd
Somers, CT 06071-1740
Phone (860) 406-0939
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All providers in Somers, CT · Massage Therapist in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 30, 2023. 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.