Lisa A Cooper, LMT

Individual provider Active NPI Massage Therapist · Centereach, NY

NPI 1952020273 · NPPES record last updated Aug 22, 2022

Key facts

NPI
1952020273
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
007255-01 (NY)
Practice address
4 Royal Oaks Dr
Centereach, NY 11720-3627
Phone
(631) 332-6755
NPI assigned
Aug 22, 2022
Sex
Female
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

State licenses

LicenseStateTypeSpecialty
007255-01NYMDAcupuncturist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 007255-01 NY Yes

Addresses

Primary practice location

4 Royal Oaks Dr
Centereach, NY 11720-3627

Mailing address

4 Royal Oaks Dr
Centereach, NY 11720-3627
Phone (631) 332-6755

Other names

  • Lisa Rummel Former name

Other providers in Centereach, NY

All providers in Centereach, NY · Massage Therapist in New York

Sources for this page

Verify at the official NPI Registry.