Revitalizing Massage Therapy PC

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

025360-1 Issued in NY

Legal business name

REVITALIZING MASSAGE THERAPY PC

Practice address

250-20 Hillside Avenue
Bellerose, NY 11426

Phone

(718) 343-0474

Fax

(718) 962-2818

NPI assigned

Jul 18, 2018

Organization subpart

No

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

Authorized official

Name

Ms. Magaly Imbachi, LMT

Title

Owner

Phone

(718) 343-0474

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1531872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531872000000",
    "number": "1477039899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250-20 HILLSIDE AVENUE",
            "city": "BELLEROSE",
            "state": "NY",
            "postal_code": "11426",
            "telephone_number": "718-343-0474",
            "fax_number": "718-965-2818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250-20 HILLSIDE AVENUE",
            "city": "BELLEROSE",
            "state": "NY",
            "postal_code": "11426",
            "telephone_number": "718-343-0474",
            "fax_number": "718-962-2818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVITALIZING MASSAGE THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-18",
        "last_updated": "2018-07-18",
        "status": "A",
        "authorized_official_last_name": "IMBACHI",
        "authorized_official_first_name": "MAGALY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-343-0474",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "025360-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Massage Therapist in Bellerose, NY
• Providers in Bellerose, 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 18, 2018; 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.