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

Nicole Irene Broderick, LMT

Individual provider Massage Therapist · NPI 1396375747

Nicole Irene Broderick, LMT is a Massage Therapist in East Islip, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2020
What do these letters mean?
LMT — Licensed Massage Therapist
A state-licensed massage therapist.

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Practice location Address checks out

99 E Main St Ste 1
East Islip, NY 11730-2538
Phone: (631) 647-8324
Fax: (631) 352-0051
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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 016018-1 (NY)

Record details

NPI number1396375747
Entity typeIndividual (Type 1)
GenderFemale
Credentials LMT
Sole proprietorYes
NPI enumeratedJanuary 23, 2020
Last updated in NPPESJanuary 23, 2020
Certification dateJanuary 23, 2020

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