Healthcare Provider Details

I. General information

NPI: 1922925932
Provider Name (Legal Business Name): YOGESH SHRIDHARE LMT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: YOGI SHRIDHARE LMT, MS

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 LEONARD ST STE 3
BELMONT MA
02478-2512
US

IV. Provider business mailing address

120 FLORENCE AVE
ARLINGTON MA
02476-7234
US

V. Phone/Fax

Practice location:
  • Phone: 617-299-1632
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number19012-MT-MT
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: