Active NPI
Migdalia Gordon, LMT
- Massage Therapist
- Ansonia, CT
National Provider Identifier
1619714342
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 004417
- Practice address
- 14 W Roosevelt Dr
Ansonia, CT 06401-1328 - Phone
- (475) 434-5005
- NPI assigned
- Jul 10, 2024
- Last updated
- Jul 10, 2024
- 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 | 004417 | CT | Primary |
Addresses
Primary practice location
14 W Roosevelt Dr
Ansonia, CT 06401-1328
Mailing address
115 Main St
Seymour, CT 06483-3166
Phone (475) 434-5005
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 |
|---|---|---|---|
| 004417 | CT | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1720569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720569600000",
"number": "1619714342",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 MAIN ST",
"city": "SEYMOUR",
"state": "CT",
"postal_code": "064833166",
"telephone_number": "475-434-5005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14 W ROOSEVELT DR",
"city": "ANSONIA",
"state": "CT",
"postal_code": "064011328",
"telephone_number": "475-434-5005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "MIGDALIA",
"name_prefix": "Ms.",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-07-10",
"last_updated": "2024-07-10",
"certification_date": "2022-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CT",
"license": "004417",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ansonia, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.