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General NPI Number Information
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NPI Number | 1124999594
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Entity Type | Individual
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Provider Name | HEATHER CARMODY LMT, CLT
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Gender | Female
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Dates
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Enumeration Date | 09/17/2025
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Last Update Date | 09/17/2025
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Provider Practice Location Address
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Address Line | 153 W 27TH ST STE 404
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City | NEW YORK
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State | NY
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Zip | 10001-0399
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Country | US
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Telephone | 212-691-0330
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Fax | 212-691-0880
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Provider Business Mailing Address
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Address Line | 211 N WALNUT ST
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City | MASSAPEQUA
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State | NY
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Zip | 11758-2908
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Country | US
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Telephone | 516-428-8342
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 017406
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License Number State | NY
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