Individual provider Active NPI

Gerardo Temporal Balid Jr., P.T

  • Physical Therapist
  • Glen Oaks, NY
National Provider Identifier
1003138975
Registry record updated Feb 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
024448 Issued in NY
Practice address
8115 255TH St
Glen Oaks, NY 11004-1414
Phone
(718) 343-3112
Fax
(718) 343-3112
NPI assigned
Feb 19, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 024448 NY Primary

Addresses

Primary practice location

8115 255TH St
Glen Oaks, NY 11004-1414

Mailing address

8115 255TH St
Glen Oaks, NY 11004-1414
Phone (718) 343-3112

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
024448NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1266537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266537600000",
    "number": "1003138975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8115 255TH ST",
            "city": "GLEN OAKS",
            "state": "NY",
            "postal_code": "110041414",
            "telephone_number": "718-343-3112",
            "fax_number": "718-343-3112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8115 255TH ST",
            "city": "GLEN OAKS",
            "state": "NY",
            "postal_code": "110041414",
            "telephone_number": "718-343-3112",
            "fax_number": "718-343-3112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALID",
        "first_name": "GERARDO",
        "middle_name": "TEMPORAL",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "P.T",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-02-19",
        "last_updated": "2010-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "024448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Oaks, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2010; 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.