Taylor Dicob, LMT
Individual provider Active NPI Massage Therapist · Croghan, NY
NPI 1487040796 · NPPES record last updated Apr 13, 2015
Key facts
- NPI
- 1487040796
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 026916 (NY)
- Practice address
- 6857 Convent St
Croghan, NY 13327-2802 - Phone
- (315) 286-1655
- NPI assigned
- Apr 13, 2015
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 026916 | NY | Yes |
Addresses
Primary practice location
6857 Convent St
Croghan, NY 13327-2802
Mailing address
6857 Convent St
Croghan, NY 13327-2802
Phone (315) 286-1655
Other providers in Croghan, NY
- Alvin Lawrence Aldrich Jr.
- Croghan Adult Care Facility LLC
- Monica R Interiano
- Darbie Jo Kloster
- Tammy Lynn Zehr
All providers in Croghan, 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 Apr 13, 2015. 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.