Active NPI
Stefanie Anne Gambino, LMT
- Massage Therapist
- Blue Point, NY
National Provider Identifier
1710584933
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 032264-01
- Practice address
- 18 Weeks St
Blue Point, NY 11715-1513 - Phone
- (631) 419-6300
- NPI assigned
- Oct 1, 2020
- 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 | 032264-01 | NY | Primary |
Addresses
Primary practice location
18 Weeks St
Blue Point, NY 11715-1513
Mailing address
1830 Avalon Pines Dr
Coram, NY 11727-5162
Phone (772) 579-8548
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 |
|---|---|---|---|
| 032264-01 | NY | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1601510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601510400000",
"number": "1710584933",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1830 AVALON PINES DR",
"city": "CORAM",
"state": "NY",
"postal_code": "117275162",
"telephone_number": "772-579-8548"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18 WEEKS ST",
"city": "BLUE POINT",
"state": "NY",
"postal_code": "117151513",
"telephone_number": "631-419-6300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAMBINO",
"first_name": "STEFANIE",
"middle_name": "ANNE",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-01",
"last_updated": "2020-10-01",
"certification_date": "2020-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NY",
"license": "032264-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Blue Point, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.