Healthcare Provider Details

I. General information

NPI: 1952226359
Provider Name (Legal Business Name): THITIKARN MYNIE MESSINA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 COURT ST STE 1217
BROOKLYN NY
11201-4410
US

IV. Provider business mailing address

731 MUNCEY RD
WEST ISLIP NY
11795-1532
US

V. Phone/Fax

Practice location:
  • Phone: 516-640-2635
  • Fax:
Mailing address:
  • Phone: 516-640-2635
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number011486
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: