Carolyn Marie Cook, MASSAGE THERAPIST
Individual provider Active NPI Massage Therapist · Bayport, NY
NPI 1477293272 · NPPES record last updated Jun 23, 2022
Key facts
- NPI
- 1477293272
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 009231 (NY)
- Practice address
- 861 Montauk Hwy
Bayport, NY 11705-1613 - Phone
- (631) 472-1005
- NPI assigned
- Mar 30, 2022
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 009231 | NY | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carolyn Cook Wellness LLC | Massage Therapist | Current |
Accepting new patients |
Locations
861 Montauk Hwy
Bayport, NY 11705
Phone (631) 419-0610
41 N Country Rd
Prt Jefferson, NY 11777
Phone (631) 331-4672
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 009231-1 | NY | |
| Massage Therapist | 225700000X | 009231 | NY | Yes |
Addresses
Primary practice location
861 Montauk Hwy
Bayport, NY 11705-1613
Mailing address
199 Bellport Ave
Medford, NY 11763-2219
Phone (631) 741-0143
Other practice location 1
199 Bellport Ave
Medford, NY 11763-2219
Phone (631) 741-0143
Other practice location 2
41 N Country Rd
Port Jefferson, NY 11777-2160
Phone (631) 472-1005
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 009231 | Other | NY | NYSHIP |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | Notes | Health Information Exchange (HIE) |
Other providers in Bayport, NY
- Heather Chandler
- Leslie Susan Cillis
- Faith Cimino
- Patrice Clemens
- Kara Constantine
- CVS Albany LLC
- Michael Dagro
- Jacqueline Danna
- Lakisha Davis
- Anthony Day
All providers in Bayport, NY · Massage Therapist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 23, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.