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KIM SU ANN DERMODY LMT
NPI 1154572352
Massage Therapist in Wading River, NY

Active since October 07, 2008
2 SOUND RD, D, WADING RIVER, NY 11792(631) 886-1999 Get Directions Write a Review

NPPES record last updated: October 7, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Kim Su Ann Dermody Lmt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KIM SU ANN DERMODY LMT (NPI 1154572352) is an individual massage therapist in Wading River, New York, licensed in New York (011574) and active in the NPI registry since October 2008.

NPPES Registry Identity

NPI1154572352
Entity TypeIndividualFemale
Primary Taxonomy225700000X
Provider Legal NameKIM SU ANN DERMODYCredential: LMT
Location Address2 SOUND RD, DWading River, NY 11792-1033
Mailing Address2 Sound Rd, DWading River, NY 11792-1033 · (631) 886-1999
Phone(631) 886-1999
Sole ProprietorYes
Enumeration DateOctober 7, 2008
✔ NPI 1154572352 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225700000X
License✔ Licensed in NY · 011574
Definition
An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.
2 SOUND RD, Wading River, NY 11792
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kim Su Dermody's NPI number?

The NPI number for Kim Su Dermody is 1154572352. It was assigned to this individual provider in the NPPES registry on October 7, 2008.

Where is Kim Su Dermody located?

Kim Su Dermody practices at 2 Sound Rd D, Wading River, NY 11792. The listed phone number is (631) 886-1999.

What is Kim Su Dermody's specialty?

The primary specialty registered for this NPI is Massage Therapist with taxonomy code 225700000X.

When was this NPI record last updated?

The NPPES record for Kim Su Dermody was last updated on October 7, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.