Krista Dicecco

Individual provider Active NPI Massage Therapist · Atlantic Highlands, NJ

NPI 1245874536 · NPPES record last updated Oct 30, 2019

Key facts

NPI
1245874536
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
18KT00769100 (NJ)
Practice address
2373 Highway 36
Atlantic Highlands, NJ 07716-2560
Phone
(732) 872-6595
NPI assigned
Oct 30, 2019
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
18KT00769100NJMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 18KT00769100 NJ Yes

Addresses

Primary practice location

2373 Highway 36
Atlantic Highlands, NJ 07716-2560

Mailing address

2373 Highway 36
Atlantic Highlands, NJ 07716-2560
Phone (732) 872-6595

Other providers in Atlantic Highlands, NJ

All providers in Atlantic Highlands, NJ · Massage Therapist in New Jersey

Sources for this page

Verify at the official NPI Registry.