Petrina Loree Derobertis, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

029913-1 Issued in NY

Practice address

1305 Middle Country Rd
Selden, NY 11784-2554

Phone

(631) 880-3810

NPI assigned

May 8, 2018

Last updated

Jun 21, 2023By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Welcome Wellness Massage Therapy P.C.

  • Massage Therapist
  • Selden, NY
  • NPI 1639881311
  NPD Authorized official

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

{
    "created_epoch": "1525737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1467941138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 HIGH ST",
            "city": "SAYVILLE",
            "state": "NY",
            "postal_code": "117821333",
            "telephone_number": "631-903-1104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 MIDDLE COUNTRY RD",
            "city": "SELDEN",
            "state": "NY",
            "postal_code": "117842554",
            "telephone_number": "631-880-3810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROBERTIS",
        "first_name": "PETRINA",
        "middle_name": "LOREE",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-08",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "029913-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Cristina Balasoto De Silva, R.N.
• Fathima Rifka Deen
• Catherine Dellorusso, LMT
• Joy Delorenzo, ATC
• Christine Caroline Demato, RN
• Edwin Manuel Diaz, OTRL
• Gavin Connor Dibble, DPT
• Patricia Diefenbach
• Diana Rose Diem
• Sam Digiovanna, RPH

• Massage Therapist in Selden, NY
• Providers in Selden, 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 Jun 21, 2023; 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.