Organization Active NPI

Consolacion O Estrella PT PC

  • Physical Therapist
  • Bronx, NY
National Provider Identifier
1003031881
Registry record updated Jan 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
018236 Issued in NY
Legal business name
CONSOLACION O ESTRELLA PT PC
Practice address
787 Lydig Avenue
Bronx, NY 10462-2144
Phone
(718) 863-7774
Fax
(718) 792-0288
NPI assigned
Apr 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Consolacion O Estrella
Title
Physical Therapist
Phone
(718) 863-7774

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 018236 NY Primary

Addresses

Primary practice location

787 Lydig Avenue
Bronx, NY 10462-2144

Mailing address

787 Lydig Avenue
Bronx, NY 10462-2144
Phone (718) 863-7774

Other identifiers 1

IdentifierTypeStateIssuer
02693281MedicaidNY

National Provider Directory

National Provider Directory

Locations

787 Lydig Ave
Bronx, NY 10462
Phone (718) 775-6025

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359590400000",
    "number": "1003031881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "787 LYDIG AVENUE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104622144",
            "telephone_number": "718-863-7774",
            "fax_number": "718-792-0288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "787 LYDIG AVENUE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104622144",
            "telephone_number": "718-863-7774",
            "fax_number": "718-792-0288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONSOLACION O ESTRELLA PT PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2013-01-31",
        "status": "A",
        "authorized_official_last_name": "ESTRELLA",
        "authorized_official_first_name": "CONSOLACION",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "718-863-7774"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "018236",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02693281",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.