Stay Active Physical Therapy, PLLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

STAY ACTIVE PHYSICAL THERAPY, PLLC

Practice address

297 Bay 20TH St Apt 2
Brooklyn, NY 11214-6011

Phone

(917) 915-3894

NPI assigned

Mar 10, 2020

Organization subpart

No

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

Authorized official

Name

Alexander Aksanov, DPT

Title

President

Phone

(917) 915-3894

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1583798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583798400000",
    "number": "1003441098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9322 3RD AVE STE 476",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112096802",
            "telephone_number": "917-915-3894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "297 BAY 20TH ST APT 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112146011",
            "telephone_number": "917-915-3894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAY ACTIVE PHYSICAL THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-10",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A",
        "authorized_official_last_name": "AKSANOV",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-915-3894",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERSITY OF THE STATE OF NEW YORK, PHYSICAL THERAPIST",
            "identifier": "0444489",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kim Stavrach
• Angelina Stavro, MSED
• Anastasia E Stavropoulos
• Iwona M Stawiarski
• Marek Stawiarski
• Stay at Home Medical Supply Inc.
• Stay Healthy Medical PC
• Stay Slim Pharmacy Inc
• Stay Well Health Medical Care PC
• Stayfit Medical Co

• Physical Therapist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2020; 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.