Provider Demographics
NPI:1093497992
Name:NEXT GENERATION WELLNESS MASSAGE THERAPY, PLLC
Entity Type:Organization
Organization Name:NEXT GENERATION WELLNESS MASSAGE THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:SALVATORE
Authorized Official - Last Name:SACCARO
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:631-835-1290
Mailing Address - Street 1:PO BOX 427
Mailing Address - Street 2:
Mailing Address - City:GREAT RIVER
Mailing Address - State:NY
Mailing Address - Zip Code:11739-0427
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:560 MAIN ST STE 2C
Practice Address - Street 2:
Practice Address - City:ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11751-3540
Practice Address - Country:US
Practice Address - Phone:631-835-1290
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-01
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty