Renee Gambino-Bonjolo, L.M.T

Individual provider Active NPI Massage Therapist · Red Hook, NY

NPI 1295029015 · NPPES record last updated Jun 9, 2011

Key facts

NPI
1295029015
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
010261 (NY)
Practice address
17 Glen Pond Dr
Red Hook, NY 12571-1840
Phone
(845) 876-7222
NPI assigned
Jun 9, 2011
Sex
Female
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 010261 NY Yes

Addresses

Primary practice location

17 Glen Pond Dr
Red Hook, NY 12571-1840

Mailing address

17 Glen Pond Dr
Red Hook, NY 12571-1840

Other providers in Red Hook, NY

All providers in Red Hook, NY · Massage Therapist in New York

Sources for this page

Verify at the official NPI Registry.