MEDICARE: MRS. JOANN MICHELLE SPINA

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	025861	NY

General Provider Information

NPI Number	:	1245672278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JOANN MICHELLE SPINA

Provider Business Mailing Address
First Line	:	9413 FLATLANDS AVE STE 1W
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11236-3713
Country	:	US
Telephone Number	:	718-241-7430
Fax Number	:

Provider Business Practice Location Address
First Line	:	9413 FLATLANDS AVE
Second Line	:	SUITE 001W
City	:	BROOKLYN
State	:	NY
Zip	:	11236-3726
Country	:	US
Telephone Number	:	718-241-7430
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2013
Last Update Date	:	02/12/2026

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