South Shore Therapeutic Massage, P.C.

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

021653 Issued in NY

Legal business name

SOUTH SHORE THERAPEUTIC MASSAGE, P.C.

Practice address

80 Merrick Rd
Amityville, NY 11701-3462

Phone

(516) 298-6558

NPI assigned

Sep 16, 2009

Last updated

Sep 16, 2009By 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

Miss Ryna Joy Bautista, RN, LMT, NCTMB

Title

Vice President

Phone

(516) 298-6558

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1253059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253059200000",
    "number": "1669705190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 MERRICK RD",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117013462",
            "telephone_number": "516-298-6558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 MERRICK RD",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117013462",
            "telephone_number": "516-298-6558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH SHORE THERAPEUTIC MASSAGE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-16",
        "last_updated": "2009-09-16",
        "status": "A",
        "authorized_official_last_name": "BAUTISTA",
        "authorized_official_first_name": "RYNA JOY",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "516-298-6558",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "RN, LMT, NCTMB"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "NY",
            "license": "021653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Shore Cardiovascular Medicine
• South Shore Cardiovascular Medicine P C
• South Shore Collaborative Psychiatry NP PLLC
• South Shore Magnetic Resonance Imaging Associates PC (Brunswick Medical Services PC)
• South Shore Optometric Associates, PC
• Marie Spaccarotella, LMSW
• Spactrum Traders LLC
• Victoria Lyn Spahn
• Gary William Spero, D.C.
• Nicole Angelina Spiegler, CTRS

• Community Health Worker in Amityville, NY
• Providers in Amityville, NY by specialty
• Community Health Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2009; 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.