Active NPI
Mary Lo, L.M.T.
- Massage Therapist
- New York, NY
National Provider Identifier
1770973547
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 012509-1
- Practice address
- 303 5TH Ave
Suite 1913
New York, NY 10016-6601 - Phone
- (212) 683-9600
- NPI assigned
- Jan 30, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 | 012509-1 | NY | Primary |
Addresses
Primary practice location
303 5TH Ave
Suite 1913
New York, NY 10016-6601
Mailing address
4335 Union St
Apt 4K
Flushing, NY 11355-3047
Phone (917) 572-3099
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 |
|---|---|---|---|
| 012509-1 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1422576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1422576000000",
"number": "1770973547",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4335 UNION ST",
"address_2": "APT 4K",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113553047",
"telephone_number": "917-572-3099"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "303 5TH AVE",
"address_2": "SUITE 1913",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100166601",
"telephone_number": "212-683-9600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LO",
"first_name": "MARY",
"name_prefix": "Ms.",
"credential": "L.M.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-01-30",
"last_updated": "2015-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NY",
"license": "012509-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.