Specialized Therapeutic Massage of Cny

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

License

026057 Issued in NY

Legal business name

SPECIALIZED THERAPEUTIC MASSAGE OF CNY

Practice address

112 Dewitt St
Syracuse, NY 13203-2890

Phone

(315) 569-3472

NPI assigned

Aug 13, 2014

Organization subpart

No

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

Authorized official

Name

Timothy Andrew Brahs, LMT

Title

Owner

Phone

(315) 569-3472

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1407888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407888000000",
    "number": "1265841472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 CAROL DR",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130312229",
            "telephone_number": "315-569-3472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 DEWITT ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032890",
            "telephone_number": "315-569-3472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALIZED THERAPEUTIC MASSAGE OF CNY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-13",
        "last_updated": "2014-08-13",
        "status": "A",
        "authorized_official_last_name": "BRAHS",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-569-3472",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "NY",
            "license": "026057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher A Spates, MD
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• Stacy Elizabeth Speicher, PA
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• Jacquelyn Anne Spencer, N.P.

• Rehabilitation Clinic/Center in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Rehabilitation Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2014; 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.