MEDICARE: KNEAD MASSAGE PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist

General Provider Information

NPI Number	:	1265317945
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KNEAD MASSAGE PC

Provider Business Mailing Address
First Line	:	36 CRANBERRY LN
Second Line	:
City	:	PLAINVIEW
State	:	NY
Zip	:	11803-6117
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	23A MIDDLE NECK RD
Second Line	:
City	:	GREAT NECK
State	:	NY
Zip	:	11021-2319
Country	:	US
Telephone Number	:	347-348-2771
Fax Number	:

Authorized Official
Title or Position	:	MASSAGE THERAPIST
Name	:	KUN LI
Credential	:
Telephone Number	:	347-348-2771

Provider Enumeration Date	:	08/11/2025
Last Update Date	:	08/11/2025

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