MEDICARE: TOTAL MASSAGE THERAPY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist

General Provider Information

NPI Number	:	1245094671
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOTAL MASSAGE THERAPY

Provider Business Mailing Address
First Line	:	1380 LOMBARDY BLVD
Second Line	:
City	:	BAY SHORE
State	:	NY
Zip	:	11706-4028
Country	:	US
Telephone Number	:	631-682-7715
Fax Number	:

Provider Business Practice Location Address
First Line	:	1380 LOMBARDY BLVD
Second Line	:
City	:	BAY SHORE
State	:	NY
Zip	:	11706-4028
Country	:	US
Telephone Number	:	631-682-7715
Fax Number	:

Authorized Official
Title or Position	:	OWNER/MASSAGE THERAPIST
Name	:	MR. ANDREW ZAYAS
Credential	:	LMT
Telephone Number	:	631-682-7715

Provider Enumeration Date	:	02/07/2024
Last Update Date	:	02/07/2024

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Directions to “TOTAL MASSAGE THERAPY ” Practice Location

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