Functional Massage & Performance

Primary specialty

Massage TherapistTaxonomy code 225700000X

Legal business name

FUNCTIONAL MASSAGE & PERFORMANCE

Practice address

1054 Little East Neck Rd
West Babylon, NY 11704-2413

Phone

(516) 355-1792

NPI assigned

Jul 22, 2022

Organization subpart

No

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

Authorized official

Name

Molly S Peck, LMTNPI 1225636954

Title

Owner

Phone

(516) 355-1792

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Molly Sara Peck, LMT

  • Massage Therapist
  • Babylon, NY
  • NPI 1225636954
  NPD Authorized official

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

{
    "created_epoch": "1658448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658448000000",
    "number": "1447985387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1054 LITTLE EAST NECK RD",
            "city": "WEST BABYLON",
            "state": "NY",
            "postal_code": "117042413",
            "telephone_number": "516-355-1792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1054 LITTLE EAST NECK RD",
            "city": "WEST BABYLON",
            "state": "NY",
            "postal_code": "117042413",
            "telephone_number": "516-355-1792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNCTIONAL MASSAGE & PERFORMANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-22",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-22",
        "status": "A",
        "authorized_official_last_name": "PECK",
        "authorized_official_first_name": "MOLLY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-355-1792",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Massage Therapist in West Babylon, NY
• Providers in West Babylon, 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 Jul 22, 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.

Verify at the official NPI Registry.