Elizabeth A. Penrose, LMT – Massage Therapist

Key facts

NPI: 1982170163
Entity type: Individual (NPI type 1)
Primary specialty: Massage Therapist 225700000X
License: 031140 (NY)
Practice address: 1098 State Route 221
Marathon, NY 13803-1108
Phone: (607) 662-5825
NPI assigned: Oct 16, 2018
Sex: Female
Sole proprietor: Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Finger Lakes Chiropractic & Massage Therapy, PLLC Chiropractor · Dryden, NY · NPI 1093049611

NPD (past)

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
031140	NY	MD	Physician Assistant

Practice roles

Organization	Specialty	Status	New patients
Finger Lakes Chiropractic & Massage Therapy, PLLC		Past since Jul 29, 2014	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Massage Therapist	225700000X	031140	NY	Yes

Addresses

Primary practice location

1098 State Route 221
Marathon, NY 13803-1108

Mailing address

87 W Main St
Dryden, NY 13053-8706
Phone (607) 844-3304

Other practice location 1

87 W Main St
Dryden, NY 13053-8706
Phone (607) 844-3304

Other providers in Marathon, NY

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

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 12, 2019. 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.

Verify at the official NPI Registry.