Active NPI
Nicole L Penkalski, L.M.T
- Massage Therapist
- Cheektowaga, NY
National Provider Identifier
1487880571
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 022769
- Practice address
- 4415 Union Rd
Cheektowaga, NY 14225 - Phone
- (716) 200-3599
- NPI assigned
- Jun 3, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 022769 | NY | Primary |
Addresses
Primary practice location
4415 Union Rd
Cheektowaga, NY 14225
Mailing address
9 Harbour LN
Cheektowaga, NY 14225-3707
Phone (716) 200-3599
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 022769 | NY | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1243987200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528070400000",
"number": "1487880571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 HARBOUR LN",
"city": "CHEEKTOWAGA",
"state": "NY",
"postal_code": "142253707",
"telephone_number": "716-200-3599"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4415 UNION RD",
"city": "CHEEKTOWAGA",
"state": "NY",
"postal_code": "14225",
"telephone_number": "716-200-3599"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENKALSKI",
"first_name": "NICOLE",
"middle_name": "L",
"name_prefix": "Ms.",
"credential": "L.M.T",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-06-03",
"last_updated": "2018-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NY",
"license": "022769",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cheektowaga, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 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.