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General NPI Number Information
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NPI Number | 1841184090
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Entity Type | Organization
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Legal Business Name | KB MASSAGE THERAPY P.C.
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Dates
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Enumeration Date | 06/04/2025
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Last Update Date | 06/04/2025
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Provider Practice Location Address
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Address Line | 58 COMMACK RD
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City | COMMACK
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State | NY
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Zip | 11725-3402
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Country | US
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Telephone | 516-660-8788
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Fax | 631-269-4111
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Provider Business Mailing Address
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Address Line | 23 HILEEN DR
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City | KINGS PARK
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State | NY
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Zip | 11754-4729
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Country | US
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Telephone | 516-660-8788
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Fax | 631-269-4111
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Authorized Official
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Title or Position | OWNER
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Name | MRS. KRISTIN NASTASIA BAMONTE
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Credential | LMT
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Telephone | 516-660-8788
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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 |
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License Number State |
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