Mary Beth Antonucci, LMT
Individual provider Active NPI Massage Therapist · Telford, PA
NPI 1710539374 · NPPES record last updated Jul 14, 2019
Key facts
- NPI
- 1710539374
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- MSG001190 (PA)
- Practice address
- 4019 Bethlehem Pike
Telford, PA 18969-1126 - Phone
- (267) 446-7830
- NPI assigned
- Jul 14, 2019
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MSG001190 | PA | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist |
225700000X | MSG001190 | PA | Yes |
Addresses
Primary practice location
4019 Bethlehem Pike
Telford, PA 18969-1126
Mailing address
4019 Bethlehem Pike
Telford, PA 18969-1126
Phone (267) 446-7830
Other providers in Telford, PA
- Advocare , LLC
- Rebecca Kathryn Afman
- Armstrong Counseling & Consulting Corporation
- Theresa J Armstrong
- Boben Babu
- Kerry Bair
- Melissa Banes
All providers in Telford, PA · Massage Therapist in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 14, 2019. 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.