Andy Julissa Garcia Soto, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

114427-01 Issued in NY

Practice address

115 Broadhollow Rd Ste 10
Melville, NY 11747-4992

Phone

(631) 990-4352

NPI assigned

Apr 6, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1649203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1609517366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 N JONES RD",
            "city": "HAMPTON BAYS",
            "state": "NY",
            "postal_code": "119463508",
            "telephone_number": "631-494-0466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 BROADHOLLOW RD STE 10",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117474992",
            "telephone_number": "631-990-4352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA SOTO",
        "first_name": "ANDY",
        "middle_name": "JULISSA",
        "name_prefix": "Miss",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-06",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "114427-01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD LIBERTY",
            "identifier": "79507690000",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@hekahealthandwellness.com",
            "affiliation": "N",
            "address_1": "115 Broadhollow Rd Ste 10",
            "city": "Melville",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117474992",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Teresa Marie Gandarillas, M.A. ED.
• Tracy Gangi, PSY.D.
• Mariana Garay
• Melissa Garber
• Vanessa Garces, RN
• Jennifer A Garcia
• Melanie Garcia
• Natalie Rose Garcia, M.S.
• Carol Garrett, PH.D., LCSW
• Julissa Garris-Shade, PSY.D.

• Massage Therapist in Melville, NY
• Providers in Melville, 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 Apr 6, 2022; 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.