Healthcare Provider Details

I. General information

NPI: 1851237630
Provider Name (Legal Business Name): TERRY WINSTON LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2026
Last Update Date: 04/25/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 BROADWAY
MALVERNE NY
11565-1635
US

IV. Provider business mailing address

55 COURTENAY RD
HEMPSTEAD NY
11550-4611
US

V. Phone/Fax

Practice location:
  • Phone: 516-887-8900
  • Fax:
Mailing address:
  • Phone: 516-641-8417
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number02814201
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: