Eastern Therapeutic LLC

Primary specialty

Massage TherapistTaxonomy code 225700000X

Legal business name

EASTERN THERAPEUTIC LLC

Practice address

336 Main St Ste B
Cromwell, CT 06416-2349

Phone

(860) 800-9180

NPI assigned

Aug 29, 2023

Last updated

Aug 29, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Crystal Pavis, LMTNPI 1568240406

Title

Massage Therapist

Phone

(860) 800-9180

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Crystal Pavis, LMT

  • Massage Therapist
  • Avon, CT
  • NPI 1568240406
  NPD Authorized official

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

{
    "created_epoch": "1693267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693267200000",
    "number": "1508641465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 CORTLAND ST",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061101406",
            "telephone_number": "860-800-9180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "336 MAIN ST STE B",
            "city": "CROMWELL",
            "state": "CT",
            "postal_code": "064162349",
            "telephone_number": "860-800-9180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN THERAPEUTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-29",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A",
        "authorized_official_last_name": "PAVIS",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_title_or_position": "MASSAGE THERAPIST",
        "authorized_official_telephone_number": "860-800-9180",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brianna Durkin
• Caitlin Dussan, BCBA
• Kaitlin Elizabeth Dutkowsky
• Rose-Mary Jane Dykas, L.O.
• Dynamic Therapies
• Tracey Easton, BCBA, LBA
• Kamryn Ebersole
• Bethany Alyson Edwards, OTR/L
• Lauren Edwards
• Sara Edwards, M.S.

• Massage Therapist in Cromwell, CT
• Providers in Cromwell, CT by specialty
• Massage Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.