National Provider Identifier

Matthew Sirvent, LMT

Matthew Sirvent, LMT is listed in the NPPES registry with a primary specialty of Massage Therapist in Ithaca, NY and a listed phone number of (607) 220-4926.

NPI 1255062550Ithaca, NYMassage Therapist

Profile Overview

NPI
1255062550
Provider Type
Individual
Primary Specialty
Massage Therapist
Enumeration Date
June 19, 2022
Last Updated
June 19, 2022

Practice Location

  • 96 Village Cir Apt 1
  • Ithaca, NY 14850-8578

Phone: (607) 220-4926

Specialties

  • Massage Therapist (225700000X)
Full Record
NPI
1255062550
Entity Type
Individual
Last Name
Sirvent
First Name
Matthew
Name Prefix
Mr.
Credential
LMT
Mailing Street Address
96 Village Cir Apt 1
Mailing City
Ithaca
Mailing State
NY
Mailing ZIP Code
14850-8578
Mailing Country
US
Practice Street Address
96 Village Cir Apt 1
Practice City
Ithaca
Practice State
NY
Practice ZIP Code
14850-8578
Practice Country
US
Practice Phone
(607) 220-4926
Enumeration Date
June 19, 2022
Last Updated
June 19, 2022
Sex
Male
Sole Proprietor
Yes
Taxonomy Group 1
193400000X Single Specialty Group
Certification Date
June 19, 2022
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Massage Therapist (225700000X)