NPIMap

Organization Active NPI

A List Physical Therapy PC

  • Early Intervention Provider Agency
  • Forest Hills, NY
National Provider Identifier
1013310481
Registry record updated Sep 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Legal business name
A LIST PHYSICAL THERAPY PC
Practice address
11949 Union Tpke Apt 4C
Forest Hills, NY 11375-6109
Phone
(646) 208-6108
Fax
(646) 810-1036
NPI assigned
Sep 30, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2014

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

Authorized official

Name
Avelino Vergara De Chavez, PTNPI 1215111216
Title
President
Phone
(646) 208-6108

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X NY Primary

Addresses

Primary practice location

11949 Union Tpke Apt 4C
Forest Hills, NY 11375-6109

Mailing address

11949 Union Tpke Apt 4C
Forest Hills, NY 11375-6109
Phone (646) 208-6108

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1412035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412035200000",
    "number": "1013310481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11949 UNION TPKE APT 4C",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113756109",
            "telephone_number": "646-208-6108",
            "fax_number": "646-810-1036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11949 UNION TPKE APT 4C",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113756109",
            "telephone_number": "646-208-6108",
            "fax_number": "646-810-1036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A LIST PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-30",
        "last_updated": "2014-09-30",
        "status": "A",
        "authorized_official_last_name": "DE CHAVEZ",
        "authorized_official_first_name": "AVELINO",
        "authorized_official_middle_name": "VERGARA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "646-208-6108",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2014; 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.