Provider Demographics
NPI:1275832487
Name:FIORENTINO, TODD JEFFREY (LMT)
Entity Type:Individual
Prefix:MR
First Name:TODD
Middle Name:JEFFREY
Last Name:FIORENTINO
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 NORTH STREET, SUITE 26B
Mailing Address - Street 2:ENERGY RISING MASSAGE THERAPY
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201
Mailing Address - Country:US
Mailing Address - Phone:732-595-6064
Mailing Address - Fax:
Practice Address - Street 1:150 NORTH STREET, SUITE 26B
Practice Address - Street 2:ENERGY RISING MASSAGE THERAPY
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201
Practice Address - Country:US
Practice Address - Phone:732-595-6064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-28
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
5559225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist