Individual provider Active NPI

Brianne Polack, LMT

  • Massage Therapist
  • Paramus, NJ
National Provider Identifier
1629370986
Registry record updated Nov 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
Practice address
205 Robin Rd
Suite 118
Paramus, NJ 07652-1449
Phone
(201) 225-1511
NPI assigned
Nov 18, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X Primary

Addresses

Primary practice location

205 Robin Rd
Suite 118
Paramus, NJ 07652-1449

Mailing address

24 Elmhurst St
Elmwood Park, NJ 07407-1319
Phone (732) 236-2722

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

NPI Registry JSON

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

{
    "created_epoch": "1290038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290038400000",
    "number": "1629370986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 ELMHURST ST",
            "city": "ELMWOOD PARK",
            "state": "NJ",
            "postal_code": "074071319",
            "telephone_number": "732-236-2722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 ROBIN RD",
            "address_2": "SUITE 118",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076521449",
            "telephone_number": "201-225-1511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLACK",
        "first_name": "BRIANNE",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-18",
        "last_updated": "2010-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paramus, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2010; 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.