Kevin Heaphy
Individual provider Active NPI Massage Therapist · Montebello, NY
NPI 1720735525 · NPPES record last updated Mar 2, 2022
Key facts
- NPI
- 1720735525
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- Practice address
- 1 Executive Blvd Ste 205
Montebello, NY 10901-4157 - Phone
- (917) 282-5206
- NPI assigned
- Mar 2, 2022
- Sex
- Male
- 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 | Yes |
Addresses
Primary practice location
1 Executive Blvd Ste 205
Montebello, NY 10901-4157
Mailing address
407 Battalion Dr
Stony Point, NY 10980-2444
Phone (917) 282-5206
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- Indian Rock Dental, PC
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All providers in Montebello, NY · Massage Therapist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 2, 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.