Organization Active NPI

Holbrook Medical Massage Inc.

  • Massage Therapist
  • Holbrook, NY
National Provider Identifier
1689258147
Registry record updated Aug 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
Legal business name
HOLBROOK MEDICAL MASSAGE INC.
Practice address
1480 Broadway Ave
Holbrook, NY 11741-5412
Phone
(516) 480-0507
NPI assigned
May 11, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2023

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

Authorized official

Name
Antonietta Colon, LMT
Title
President
Phone
(631) 983-7659

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225700000X Primary

Addresses

Primary practice location

1480 Broadway Ave
Holbrook, NY 11741-5412

Mailing address

58 1St Ave
Medford, NY 11763-3837
Phone (631) 983-7659

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1620691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692316800000",
    "number": "1689258147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 1ST AVE",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117633837",
            "telephone_number": "631-983-7659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1480 BROADWAY AVE",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117415412",
            "telephone_number": "516-480-0507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLBROOK MEDICAL MASSAGE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-11",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A",
        "authorized_official_last_name": "COLON",
        "authorized_official_first_name": "ANTONIETTA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-983-7659",
        "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": []
}

Other providers in Holbrook, NY

Sources for this page

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