Individual provider · Type 1 NPI

Aleksandr Degtyarev, LMT

Massage Therapist · Port Jefferson, NY

NPI number 1619651387 Active

Practice location

318 Wynn Ln
Port Jefferson, NY 11777-1670

Call (917) 224-0464 Map

Mailing address

81 Westchester Dr
Rocky Point, NY 11778-8875

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X032816 (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 1619651387

Aleksandr Degtyarev, LMT's National Provider Identifier is 1619651387, issued on Jun 13, 2023. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Port Jefferson, NY. The record was last updated on Jun 13, 2023.