Koehler Leslie Radder, MASSAGE THERAPIST

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

030336 Issued in NY

Practice address

4214 Clinton St
West Seneca, NY 14224-1606

Phone

(716) 675-2225

NPI assigned

Dec 26, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Chiro First Wellness Center

  • Exclusive Provider Organization
  • West Seneca, NY
  • NPI 1902271414
  NPD (past)
• Chiro One Wellness P. C.

  • Nutrition Chiropractor
  • West Seneca, NY
  • NPI 1285926782
  NPD (past)

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

{
    "created_epoch": "1545782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545782400000",
    "number": "1184196461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4214 CLINTON ST",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "142241606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4214 CLINTON ST",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "142241606",
            "telephone_number": "716-675-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADDER",
        "first_name": "KOEHLER",
        "middle_name": "LESLIE",
        "credential": "MASSAGE THERAPIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-12-26",
        "last_updated": "2018-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "030336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Agnes Vida Quebral, MD
• Queen City Medical Supply, Inc.
• Josephine Queen, RN
• Gloria S Quirante, MD
• Rachael Schneider Licensed Behavior Analyst PLLC
• Michael P Rade, MD
• Emily Radnovich
• Barbara Z. Radolinski, MD
• Shannon Raimondo
• Susan C Rajczak, ANP

• Massage Therapist in West Seneca, NY
• Providers in West Seneca, NY by specialty
• Massage Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2018; 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.