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ALEKSANDR DEGTYAREV LMT
NPI 1619651387
Massage Therapist in Port Jefferson, NY

Active since June 13, 2023
318 WYNN LN, PORT JEFFERSON, NY 11777(917) 224-0464 Get Directions Write a Review

NPPES record last updated: June 13, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Aleksandr Degtyarev Lmt NPPES

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

ALEKSANDR DEGTYAREV LMT (NPI 1619651387) is an individual massage therapist in Port Jefferson, New York, licensed in New York (032816) and active in the NPI registry since June 2023.

NPPES Registry Identity

NPI1619651387
Entity TypeIndividualMale
Primary Taxonomy225700000X
Provider Legal NameALEKSANDR DEGTYAREVCredential: LMT
Location Address318 WYNN LNPort Jefferson, NY 11777-1670
Mailing Address81 Westchester DrRocky Point, NY 11778-8875 · (917) 224-0464
Phone(917) 224-0464
Sole ProprietorYes
Enumeration DateJune 13, 2023
NPPES CertifiedJune 13, 2023
✔ NPI 1619651387 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 · 032816
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.
318 WYNN LN, Port Jefferson, NY 11777
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 Aleksandr Degtyarev's NPI number?

The NPI number for Aleksandr Degtyarev is 1619651387. It was assigned to this individual provider in the NPPES registry on June 13, 2023.

Where is Aleksandr Degtyarev located?

Aleksandr Degtyarev practices at 318 Wynn Ln, Port Jefferson, NY 11777. The listed phone number is (917) 224-0464.

What is Aleksandr Degtyarev'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 Aleksandr Degtyarev was last updated on June 13, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.