NICOLE IRENE BRODERICK LMT
NPI 1396375747
Massage Therapist in East Islip, NY

Q: What is Nicole Broderick's NPI number?

The NPI number for Nicole Broderick is 1396375747. It was assigned to this individual provider in the NPPES registry on January 23, 2020.

Q: What is Nicole Broderick's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Nicole Broderick was last updated on January 23, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since January 23, 2020

99 E MAIN ST STE 1, EAST ISLIP, NY 11730(631) 647-8324(631) 352-0051 Get Directions Write a Review

NPPES record last updated: January 23, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Nicole Irene Broderick Lmt NPPES

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

NICOLE IRENE BRODERICK LMT (NPI 1396375747) is an individual massage therapist in East Islip, New York, licensed in New York (016018-1) and active in the NPI registry since January 2020.

NPPES Registry Identity

NPI1396375747

Entity TypeIndividualFemale

Primary Taxonomy225700000X

Provider Legal NameNICOLE IRENE BRODERICKCredential: LMT

Location Address99 E MAIN ST STE 1East Islip, NY 11730-2538

Mailing Address99 E Main St Ste 1East Islip, NY 11730-2538 · (631) 647-8324 · Fax (631) 352-0051

Phone(631) 647-8324

Fax(631) 352-0051

Sole ProprietorYes

Enumeration DateJanuary 23, 2020

✔ NPI 1396375747 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 · 016018-1

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.

99 E MAIN ST STE 1, East Islip, NY 11730

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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JOHN VASSALLO ACUPUNCTURIST

Acupuncturist

99 E MAIN ST STE 1
EAST ISLIP, NY 11730

Suffolk County (631) 786-6406

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 Nicole Broderick's NPI number?

The NPI number for Nicole Broderick is 1396375747. It was assigned to this individual provider in the NPPES registry on January 23, 2020.

Where is Nicole Broderick located?

Nicole Broderick practices at 99 E Main St Ste 1, East Islip, NY 11730. The listed phone number is (631) 647-8324.

What is Nicole Broderick'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 Nicole Broderick was last updated on January 23, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.