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Aleksandr Degtyarev, LMT
Massage Therapist in Port Jefferson, New York
NPI 1619651387

Aleksandr Degtyarev is a Massage Therapist based in Rocky Point, NY. Aleksandr Degtyarev practices in Port Jefferson, NY and has the professional credentials of LMT. The NPI Number for Aleksandr Degtyarev is 1619651387 and holds a License No. 032816 (New York).

The current practice location address for Aleksandr Degtyarev is 318 Wynn Ln, Port Jefferson, NY and can be reached out via phone at 917-224-0464.

Location: 318 Wynn Ln, Port Jefferson, NY, 11778-8875
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1619651387
Provider Name
Aleksandr Degtyarev
Credential
LMT
Provider Entity Type
Individual
Gender
Male
Address
318 Wynn Ln, Port Jefferson, NY, 11778-8875
Phone Number
917-224-0464
Fax Number
Provider Enumeration Date
06/13/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
318 Wynn Ln
City
Port Jefferson
State
New York
Zip
11777-1670
Phone Number
917-224-0464
Fax Number
person
Provider Business Mailing Address Details
Address
318 Wynn Ln
City
Port Jefferson
State
New York
Zip
11777-1670
Phone Number
917-224-0464
Fax Number
person
Provider's Taxonomy Details 1
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Massage Therapist
Speciality
-
Taxonomy
225700000X
License No.
032816 (New York)
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.
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