Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mountainside Diversified

Organization Massage Therapist · NPI 1689251712

Mountainside Diversified is a Massage Therapist in Staten Island, New York. Registered with an NPI since 2021.

In the registry since
2021

Practice location Address checks out

1324 Forest Ave
Staten Island, NY 10302-2044
Phone: (877) 480-8038
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Massage Therapist (primary) Taxonomy 225700000X

Record details

NPI number1689251712
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Heather Miller — Partner/Manager · (877) 480-8038
NPI enumeratedMarch 25, 2021
Last updated in NPPESMarch 25, 2021
Certification dateMarch 25, 2021
Mailing addressPo Box 20521, Staten Island, NY 10302-0521

Other providers in Staten Island