Active NPI
Lyudmyla Gaydukova
- Massage Therapist
- New York, NY
National Provider Identifier
1336876127
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 025856-01
- Practice address
- 311 W 24TH St Apt 10C
New York, NY 10011-1567 - Phone
- (646) 263-3839
- NPI assigned
- Aug 2, 2022
- Last updated
- Aug 2, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 025856-01 | NY | Primary |
Addresses
Primary practice location
311 W 24TH St Apt 10C
New York, NY 10011-1567
Mailing address
311 W 24TH St Apt 10C
New York, NY 10011-1567
Phone (212) 204-8779
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 025856-01 | Other | NY | OFFICE OF THE PROFESSIONS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 025856-01 | NY | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1659398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659398400000",
"number": "1336876127",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "311 W 24TH ST APT 10C",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100111567",
"telephone_number": "212-204-8779"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "311 W 24TH ST APT 10C",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100111567",
"telephone_number": "646-263-3839"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAYDUKOVA",
"first_name": "LYUDMYLA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-08-02",
"last_updated": "2022-08-02",
"certification_date": "2022-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NY",
"license": "025856-01",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OFFICE OF THE PROFESSIONS",
"identifier": "025856-01",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.