Individual provider · Type 1 NPI

Lisa Balloni, LMT

Massage Therapist · Port Jefferson Station, NY

NPI number 1972169308 Active

Practice location

1041 Route 112
Port Jefferson Station, NY 11776-6000

Call (631) 828-4545 Map

Mailing address

66 Rialto Way
Patchogue, NY 11772-3566

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X015698-1 (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 1972169308

Lisa Balloni, LMT's National Provider Identifier is 1972169308, issued on May 10, 2019. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Port Jefferson Station, NY. The record was last updated on May 10, 2019.