Jaclynn Brandi, LMT
Individual provider Active NPI Massage Therapist · Islip, NY
NPI 1689314734 · NPPES record last updated Mar 29, 2022
Key facts
- NPI
- 1689314734
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 016202 (NY)
- Practice address
- 34 Ocean Ave
Islip, NY 11751-3804 - Phone
- (631) 790-4758
- NPI assigned
- Mar 29, 2022
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 016202 | NY | Yes |
Addresses
Primary practice location
34 Ocean Ave
Islip, NY 11751-3804
Mailing address
313 N Dunton Ave
East Patchogue, NY 11772-5543
Phone (631) 790-4758
Other providers in Islip, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 29, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.