Individual provider Active NPI

Mark David Pukmel, LMT

  • Massage Therapist
  • Poughkeepsie, NY
National Provider Identifier
1942948773
Registry record updated May 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
017405-1 Issued in NY
Practice address
9 Vassar Street
Suite 20
Poughkeepsie, NY 12601-3022
Phone
(845) 518-2708
NPI assigned
May 23, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 017405-1 NY Primary

Addresses

Primary practice location

9 Vassar Street
Suite 20
Poughkeepsie, NY 12601-3022

Mailing address

9 Vassar Street
Suite 20
Poughkeepsie, NY 12601-3022
Phone (845) 518-2708

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

LicenseStateTypeSpecialty
017405-1NYMDMassage Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1653264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653264000000",
    "number": "1942948773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 VASSAR STREET",
            "address_2": "SUITE 20",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126013022",
            "telephone_number": "845-518-2708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 VASSAR STREET",
            "address_2": "SUITE 20",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126013022",
            "telephone_number": "845-518-2708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUKMEL",
        "first_name": "MARK",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-23",
        "last_updated": "2022-05-23",
        "certification_date": "2022-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "017405-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.