Healthcare Provider Details

I. General information

NPI: 1467385294
Provider Name (Legal Business Name): CATHERINE EDRA MASANGKAY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SALVENCIO EDRA MASANGKAY LMT

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 CYPRESS AVENUE SUITES 28 & 32
BROOKLYN NY
11237
US

IV. Provider business mailing address

4630 59TH ST # 3
WOODSIDE NY
11377-5536
US

V. Phone/Fax

Practice location:
  • Phone: 347-541-9226
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number033148
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: