MS. JACQUELINE DEDOMENICO (NPI# 1043817018) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043817018 |
| Entity Type | Individual |
| Full Name | MS. JACQUELINE DEDOMENICO |
| Credential | LMT |
| Practice Address |
72 Parkhill Ave Massapequa NY 11758-4553 |
| Practice Telephone | 5168402383 |
| Enumeration Date | 2020-10-02 |
| Last Update Date | 2020-10-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | 015300-1 | NY | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
72 PARKHILL AVE |
| City | MASSAPEQUA |
| State | NY |
| Zip Code | 11758-4553 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811535339 | Jamie Leigh Disilvio | Licensed Practical Nurse | 24 Amity Pl., Massapequa, NY 11758 | 2019-12-16 |
| 1548787955 | June H Friedman | Social Worker | 78 North Pine Street, North Massapequa, NY 11758 | 2017-08-25 |
| 1376078568 | Caitlin Bree Kennedy | Acupuncturist | 507 Hicksville Road, Massapequa, NY 11758 | 2017-04-25 |
| 1932645561 | Maria Amato | Specialist | 277 Division Ave, Massapequa, NY 11758 | 2017-01-06 |
| 1164877270 | Marylou Lawson | Early Intervention Provider Agency | 87 N Pine Street, N Massapequa, NY 11758 | 2016-04-26 |
| 1417314196 | Tender Heart Senior Care Corp | In Home Supportive Care | 24 Peconic Dr, Massapequa, NY 11758 | 2016-01-26 |
| 1316328420 | Theresa Mackey | Behavioral Analyst | 19 Oxford Avenue, N. Massapequa, NY 11758 | 2015-06-15 |
| 1932596590 | Bianca Ferrantelli | Specialist | 13 Alhabra Rd, Apt 5, Massapequa, NY 11758 | 2015-04-22 |
| 1245625797 | Medwell Medical PC | Pain Medicine | 1065a North Broadway, Massapequa, NY 11758 | 2015-04-01 |
| 1053703926 | Joseph Sgaglione | Physical Therapist | 503 Wright Drive, Massapequa, NY 11758 | 2015-03-02 |
| Find all providers in zip 11758 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275150468 | Mariana A. Ambrosio-perry | Massage Therapist | 727 N Broadway Ste A1, Massapequa, NY 11758-2348 | 2020-07-03 |
| 1215573696 | Paula Kolano | Massage Therapist | 690 Broadway Ste 1, Massapequa, NY 11758-2388 | 2019-11-21 |
| 1487140505 | Francesca Mcquade | Massage Therapist | 930 N Broadway Ste 100, Massapequa, NY 11758-2394 | 2018-07-02 |
| 1417319252 | Emerge Yoga & Wellness | Massage Therapist | 623 Broadway, Massapequa, NY 11758-5027 | 2016-03-22 |
| 1255973939 | Vanessa J Cafiero | Massage Therapist | 623 Broadway, Massapequa, NY 11758-5027 | 2019-10-14 |
| 1144862822 | Mark Doherty | Massage Therapist | 623 Broadway, Massapequa, NY 11758-5027 | 2019-10-14 |
| 1508416751 | Timothy Daniel Cordaro | Massage Therapist | 930 N Broadway Ste 100, Massapequa, NY 11758-2394 | 2019-09-18 |
| 1164918736 | Diane Elaine Mcmillan | Massage Therapist | 913 N Broadway, Massapequa, NY 11758-2364 | 2018-07-07 |
| 1710475009 | Jennifer J Charvat | Massage Therapist | 930 N Broadway, Massapequa, NY 11758-2394 | 2018-04-23 |
| 1427545763 | Intrinsic Energy Acupuncture Pllc | Massage Therapist | 930 N Broadway, Massapequa, NY 11758-2394 | 2018-04-20 |
| Find all providers in MASSAPEQUA | ||||
| City | MASSAPEQUA |
| Zip Code | 11758 |
Please comment or provide details below to improve the information on MS. JACQUELINE DEDOMENICO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.