MARK DOHERTY (NPI# 1144862822) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144862822 |
| Entity Type | Individual |
| Full Name | MARK DOHERTY |
| Credential | LMT |
| Practice Address |
623 Broadway Massapequa NY 11758-5027 |
| Practice Telephone | 5167811078 |
| Mailing Telephone | 5167811078 |
| Enumeration Date | 2019-10-14 |
| Last Update Date | 2019-10-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | 030560 | NY | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669823043 | Mark Doherty | Behavioral Analyst | 7 Bishop St, Framingham, MA 01702-8323 | 2016-06-27 |
| 1194818872 | Mark E Doherty | Dentist | 1155 Purchase St., New Bedford, MA 02740 | 2006-10-02 |
| 1952400079 | Mark Robert Doherty | Dentist | 26 Surfside Rd, Pryor, OK 74361-3306 | 2006-09-22 |
| 1801892260 | Mark J. Doherty | Dermatology | 1151 Ellis St Ste 202, Bellingham, WA 98225-5203 | 2005-06-21 |
| 1497038145 | Mark Thomas Doherty | Pharmacist | 120 E Main St, Streator, IL 61364-2901 | 2011-09-20 |
| 1285696674 | Mark Doherty | Oral & Maxillofacial Surgery | 1353 Dorchester Ave, Dorchester, MA 02122-2932 | 2006-04-03 |
| 1467423871 | Mark Gerard Doherty | Obstetrics & Gynecology | 1625 N George Mason Dr, Suite 475, Arlington, VA 22205-3683 | 2006-02-01 |
| Street Address |
623 BROADWAY |
| City | MASSAPEQUA |
| State | NY |
| Zip Code | 11758-5027 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417319252 | Emerge Yoga & Wellness | Massage Therapist | 623 Broadway, Massapequa, NY 11758-5027 | 2016-03-22 |
| 1477192987 | Jessica H Pivnik | Rehabilitation Practitioner | 623 Broadway, Massapequa, NY 11758-5027 | 2019-12-31 |
| 1285273797 | Tabitha Ochtera | Rehabilitation Practitioner | 623 Broadway, Massapequa, NY 11758-5027 | 2019-12-31 |
| 1720627235 | Maura Beth Cox | Rehabilitation Practitioner | 623 Broadway, Massapequa, NY 11758-5027 | 2019-12-31 |
| 1659910164 | Samara Oliveira | Rehabilitation Practitioner | 623 Broadway, Massapequa, NY 11758-5027 | 2019-12-31 |
| 1760021273 | Amanda Hollyday | Rehabilitation Practitioner | 623 Broadway, Massapequa, NY 11758-5027 | 2019-12-31 |
| 1578102083 | Patricia Depinho | Rehabilitation Practitioner | 623 Broadway, Massapequa, NY 11758-5027 | 2019-12-31 |
| 1306485818 | Sydnie Tamberino | Rehabilitation Practitioner | 623 Broadway, Massapequa, NY 11758-5027 | 2019-12-31 |
| 1255973939 | Vanessa J Cafiero | Massage Therapist | 623 Broadway, Massapequa, NY 11758-5027 | 2019-10-14 |
| 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 |
|---|---|---|---|---|
| 1043817018 | Jacqueline Dedomenico | Massage Therapist | 72 Parkhill Ave, Massapequa, NY 11758-4553 | 2020-10-02 |
| 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 |
| 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 MARK DOHERTY.
| 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.