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MOUNTAINSIDE DIVERSIFIED
NPI 1689251712
Massage Therapist in Staten Island, NY

Active since March 25, 2021
1324 FOREST AVE, STATEN ISLAND, NY 10302(877) 480-8038 Get Directions Write a Review

NPPES record last updated: March 25, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mountainside Diversified NPPES

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

MOUNTAINSIDE DIVERSIFIED (NPI 1689251712) is a healthcare organization registered as a massage therapist in Staten Island, New York and active in the NPI registry since March 2021. The organization lists Heather Miller, Partner/manager, as its authorized official.

NPPES Registry Identity

NPI1689251712
Entity TypeOrganization
Primary Taxonomy225700000X
Legal Business NameMOUNTAINSIDE DIVERSIFIED
Location Address1324 FOREST AVEStaten Island, NY 10302-2044
Mailing AddressPo Box 20521Staten Island, NY 10302-0521 · (877) 480-8038
Phone(877) 480-8038
Organization SubpartNo
Authorized OfficialHeather MillerPartner/manager · (877) 480-8038
Enumeration DateMarch 25, 2021
NPPES CertifiedMarch 25, 2021
✔ NPI 1689251712 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
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.
1324 FOREST AVE, Staten Island, NY 10302
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

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

STATEN ISLAND LITHOTRIPSY LLC
Clinic/Center (Ambulatory Surgical)
1324 FOREST AVE, #228
STATEN ISLAND, NY 10302
Richmond County (520) 323-8732
MR. JASON CHARLES LMT, LMBT
Massage Therapist
1324 FOREST AVE, STE 125
STATEN ISLAND, NY 10302
Richmond County (646) 838-1729
DANIELLE PUGLIESE LMHC-LP
Counselor (Mental Health)
1324 FOREST AVE
STATEN ISLAND, NY 10302
Richmond County (718) 283-4267

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 Mountainside Diversified's NPI number?

The NPI number for Mountainside Diversified is 1689251712. It was assigned to this organization in the NPPES registry on March 25, 2021.

Where is Mountainside Diversified located?

Mountainside Diversified is located at 1324 Forest Ave, Staten Island, NY 10302. The listed phone number is (877) 480-8038.

What is Mountainside Diversified'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 Mountainside Diversified was last updated on March 25, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.