Active NPI
Amanda McNulty, LMT
- Massage Therapist
- Bay Shore, NY
National Provider Identifier
1689444945
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 029230
- Practice address
- 1850 Sunrise Hwy
Bay Shore, NY 11706-6012 - Phone
- (631) 886-4989
- NPI assigned
- Jan 8, 2024
- Sex
- Female
- Sole proprietor
- No
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 | 029230 | NY | Primary |
Addresses
Primary practice location
1850 Sunrise Hwy
Bay Shore, NY 11706-6012
Mailing address
217 11TH St
West Babylon, NY 11704-3530
Phone (631) 935-3403
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 |
|---|---|---|---|
| 029230 | NY | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1704672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704672000000",
"number": "1689444945",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "217 11TH ST",
"city": "WEST BABYLON",
"state": "NY",
"postal_code": "117043530",
"telephone_number": "631-935-3403"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1850 SUNRISE HWY",
"city": "BAY SHORE",
"state": "NY",
"postal_code": "117066012",
"telephone_number": "631-886-4989"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCNULTY",
"first_name": "AMANDA",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-01-08",
"last_updated": "2024-01-08",
"certification_date": "2024-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NY",
"license": "029230",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bay Shore, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 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.