Consuelo Alcorta
Individual provider Active NPI Massage Therapist · Munster, IN
NPI 1871908756 · NPPES record last updated Jun 30, 2014
Key facts
- NPI
- 1871908756
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- MT20900105 (IN)
- Practice address
- 706 Ridge Rd
Munster, IN 46321-1612 - Phone
- (219) 836-8890
- Fax
- (219) 836-2344
- NPI assigned
- Jun 30, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
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 |
|---|---|---|---|
| MT20900105 | IN | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Trimboli Bogie Inc PC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MT20900105 | IN | Yes |
Addresses
Primary practice location
706 Ridge Rd
Munster, IN 46321-1612
Mailing address
706 Ridge Rd
Munster, IN 46321-1612
Phone (219) 836-8890
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MT20900105 | Other | IN | LICENSE NUMBER |
Other providers in Munster, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 30, 2014. 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.