Individual provider · Type 1 NPI

Matthew Moderno, LMT

Massage Therapist · Baldwin, NY

NPI number 1104563063 Active

Practice location

2789 Milburn Ave
Baldwin, NY 11510-4119

Call (516) 457-7371 Map

Mailing address

PO Box 22
Merrick, NY 11566-0022

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X028230 (NY)

Massage Therapist: 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.

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About NPI 1104563063

Matthew Moderno, LMT's National Provider Identifier is 1104563063, issued on May 12, 2022. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Baldwin, NY. The record was last updated on May 12, 2022.