MEDICARE: NITTAYA BURAPHAN

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	21991	NC

General Provider Information

NPI Number	:	1861342628
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NITTAYA BURAPHAN

Provider Business Mailing Address
First Line	:	813 WENDY WAY
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27712-9259
Country	:	US
Telephone Number	:	919-808-8986
Fax Number	:

Provider Business Practice Location Address
First Line	:	3811 N ROXBORO ST
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27704-5800
Country	:	US
Telephone Number	:	919-808-8986
Fax Number	:

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

Provider Enumeration Date	:	01/31/2026
Last Update Date	:	01/31/2026

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Directions to “ NITTAYA BURAPHAN ” Practice Location

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