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

Matthew Moderno, LMT

Individual provider Massage Therapist · NPI 1104563063

Matthew Moderno, LMT is a Massage Therapist in Baldwin, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2022
What do these letters mean?
LMT — Licensed Massage Therapist
A state-licensed massage therapist.

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Practice location Address checks out

2789 Milburn Ave
Baldwin, NY 11510-4119
Phone: (516) 457-7371
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Massage Therapist (primary) Taxonomy 225700000X · Licence 028230 (NY)

Record details

NPI number1104563063
Entity typeIndividual (Type 1)
GenderMale
Credentials LMT
Sole proprietorYes
NPI enumeratedMay 12, 2022
Last updated in NPPESMay 12, 2022
Certification dateApril 29, 2022
Mailing addressPo Box 22, Merrick, NY 11566-0022

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