National Provider Identifier
Deidre Medina, L.M.T.
Deidre Medina, L.M.T. is listed in the NPPES registry with a primary specialty of Massage Therapist in Buffalo, NY and a listed phone number of (716) 292-6113.
Profile Overview
- NPI
- 1942616230
- Provider Type
- Individual
- Primary Specialty
- Massage Therapist
- Enumeration Date
- July 07, 2014
- Last Updated
- July 07, 2014
Practice Location
- 120 Eller Ave
- Buffalo, NY 14211-2115
Phone: (716) 292-6113
Specialties
- Massage Therapist (225700000X)
Full Record
- NPI
- 1942616230
- Entity Type
- Individual
- Last Name
- Medina
- First Name
- Deidre
- Name Prefix
- Mrs.
- Credential
- L.M.T.
- Mailing Street Address
- 120 Eller Ave
- Mailing City
- Buffalo
- Mailing State
- NY
- Mailing ZIP Code
- 14211-2115
- Mailing Country
- US
- Mailing Phone
- (716) 292-6113
- Practice Street Address
- 120 Eller Ave
- Practice City
- Buffalo
- Practice State
- NY
- Practice ZIP Code
- 14211-2115
- Practice Country
- US
- Practice Phone
- (716) 292-6113
- Enumeration Date
- July 07, 2014
- Last Updated
- July 07, 2014
- Sex
- Female
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Massage Therapist (225700000X)