IDA M. GAMMON-WILSON (NPI# 1629090519) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629090519 |
| Entity Type | Individual |
| Full Name | IDA M. GAMMON-WILSON |
| Credential | LMT, CBT |
| Practice Address |
690 Maine Ave Farmingdale ME 04344-1539 |
| Mailing Address |
Po Box 502 Hallowell ME 04347-0502 |
| Practice Telephone | 2076224062 |
| Practice Fax Number | 2076224062 |
| Mailing Telephone | 2076224062 |
| Mailing Fax Number | 2076224062 |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | ME#MT6 | ME | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
690 MAINE AVE |
| City | FARMINGDALE |
| State | ME |
| Zip Code | 04344-1539 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881637114 | Michele G Stevens | Physical Therapist | 14 2nd St, Farmingdale, ME 04344 | 2006-06-14 |
| 1588172811 | Maura Stottler | Specialist/Technologist | 687 Maine Ave, Farmingdale, ME 04344-1526 | 2018-01-22 |
| 1043287485 | Davis Long Term Care Group Inc | Assisted Living Facility | 647 Maine Ave, Farmingdale, ME 04344-1526 | 2006-03-03 |
| 1346605896 | Dltc Healthcare LLC | Assisted Living Facility | 647 Maine Ave, Farmingdale, ME 04344-1526 | 2015-12-29 |
| 1780885806 | Davis Long Term Care Group Inc | Assisted Living Facility | 647 Maine Ave, Farmingdale, ME 04344-1526 | 2007-05-29 |
| 1861859662 | Jennifer Leigh Hall | Social Worker | 227 Park St, Farmingdale, ME 04344-1527 | 2016-01-25 |
| 1578893905 | Diane Smith | Developmental Therapist | 15 Beech St, Farmingdale, ME 04344-1603 | 2010-01-07 |
| 1295395846 | Courtney Ross | Occupational Therapist | 15 Hasson St # 1613, Farmingdale, ME 04344-1613 | 2019-06-17 |
| 1760514954 | Lisa M Mazzola | Occupational Therapist | 15 Hasson St, Farmingdale, ME 04344-1613 | 2007-03-12 |
| 1235773730 | Emily Megan Ouellette | Occupational Therapy Assistant | 15 Hasson St, Farmingdale, ME 04344-1613 | 2019-10-29 |
| Find all providers in zip 04344 | ||||
| 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 |
|---|---|---|---|---|
| 1285231571 | Calvin H Canales | Massage Therapist | 535 Secatogue Ave, Farmingdale, NY 11735-4335 | 2020-10-08 |
| 1598381337 | Stefanie Verity | Massage Therapist | 23 9th Ave, Farmingdale, NY 11735-5742 | 2020-06-17 |
| 1073151197 | Center Island Massage PC | Massage Therapist | 34 Hempstead Turnpike, Suite E, Farmingdale, NY 11735 | 2019-12-19 |
| 1710470117 | Andrew Zayas | Massage Therapist | 34 Hempstead Tpke Ste 6, Farmingdale, NY 11735-2034 | 2018-06-11 |
| 1023258597 | Brian L. Figueroa | Massage Therapist | 34 Plitt Ave, Farmingdale, NY 11735-5105 | 2009-02-24 |
| 1912144056 | Karen E Rosen | Massage Therapist | 45 Michel Ave, Farmingdale, NY 11735-4528 | 2009-01-12 |
| 1841441227 | Courtney Rubenacker | Massage Therapist | 672 Fulton St, Apartment 1g, Farmingdale, NY 11735-3457 | 2008-10-03 |
| 1932710415 | Min Zhao | Massage Therapist | 34 Hempstead Tpke, Farmingdale, NY 11735-2034 | 2020-08-10 |
| 1760004048 | Tracey Washington | Massage Therapist | 34 Hempstead Tpke, Farmingdale, NY 11735-2034 | 2020-05-10 |
| 1558996074 | Jewana White | Massage Therapist | 34 Hempstead Tpke, Farmingdale, NY 11735-2034 | 2020-03-04 |
| Find all providers in FARMINGDALE | ||||
| City | FARMINGDALE |
| Zip Code | 04344 |
Please comment or provide details below to improve the information on IDA M. GAMMON-WILSON.
| 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.