Miaomiao Gong

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

032286 Issued in NY

Practice address

248 Larkfield Rd Ste C
East Northport, NY 11731-2443

Phone

(631) 985-7770

NPI assigned

May 31, 2024

Last updated

Sep 20, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1717113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1326889775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22511 59TH AVE FL 2",
            "city": "OAKLAND GDNS",
            "state": "NY",
            "postal_code": "113642312",
            "telephone_number": "646-215-0910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "248 LARKFIELD RD STE C",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117312443",
            "telephone_number": "631-985-7770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONG",
        "first_name": "MIAOMIAO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-31",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "032286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Vincent Giudice, MS, OTR/L
• Anita Glashow
• Susan Glover
• Glow Wellness Care Medical PLLC
• Theodore Lyle Goldman, M.D.
• Diane L. Gorenstein, LCSW
• Dianna R Gott, LCSW
• Martin I Granoff, MD
• Johanna Grant, M.S. CCC-SLP
• Nicole L Grimaldi, DPT

• Massage Therapist in East Northport, NY
• Providers in East Northport, 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 Sep 20, 2024; 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.