Individual provider Active NPI

Marian Kraeling, LMT

  • Massage Therapist
  • Baldwin, NY
National Provider Identifier
1962998872
Registry record updated Jul 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
010196-1 Issued in NY
Practice address
1028 Pacific St
Baldwin, NY 11510-4434
Phone
(516) 417-6715
NPI assigned
Jul 3, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2018

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 010196-1 NY Primary

Addresses

Primary practice location

1028 Pacific St
Baldwin, NY 11510-4434

Mailing address

1028 Pacific St
Baldwin, NY 11510-4434
Phone (516) 417-6715

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
010196-1NYMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1530576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530576000000",
    "number": "1962998872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1028 PACIFIC ST",
            "city": "BALDWIN",
            "state": "NY",
            "postal_code": "115104434",
            "telephone_number": "516-417-6715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1028 PACIFIC ST",
            "city": "BALDWIN",
            "state": "NY",
            "postal_code": "115104434",
            "telephone_number": "516-417-6715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAELING",
        "first_name": "MARIAN",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-03",
        "last_updated": "2018-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "010196-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baldwin, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2018; 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.