BRENDA MARIE RANDOLPH LMT - NPI 1639949076 - Massage Therapist in Lindenhurst, NY

Q: What is the provider's specialty?

The provider's specialty is Massage Therapist with taxonomy code 225700000X.

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About Brenda Marie Randolph Lmt NPPES

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

BRENDA MARIE RANDOLPH LMT (NPI 1639949076) is an individual massage therapist in Lindenhurst, New York, licensed in New York (032334) and active in the NPI registry since January 2024.

NPPES Registry Identity

NPI1639949076

Entity TypeIndividualFemale

Primary Taxonomy225700000X

Provider Legal NameBRENDA MARIE RANDOLPHCredential: LMT

Location Address672 WELLWOOD AVE UNIT 2Lindenhurst, NY 11757-1677

Mailing Address642 Sunrise Hwy Apt AWest Babylon, NY 11704-6023 · (631) 682-2243

Phone(631) 225-2623

Sole ProprietorNo

Enumeration DateJanuary 8, 2024

NPPES CertifiedJanuary 5, 2024

✔ NPI 1639949076 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 · 032334

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.

672 WELLWOOD AVE UNIT 2, Lindenhurst, NY 11757

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