Joseph Bandura
Individual provider Active NPI Physical Therapist · Brookpark, OH
NPI 1023073129 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1023073129
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT - 7277 (OH)
- Practice address
- 15900 Snow Rd
Suite 500
Brookpark, OH 44142-2859 - Phone
- (216) 265-3454
- NPI assigned
- Apr 20, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT - 7277 | OH | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthopaedic Associates, Inc | Past | Accepting new patients | |
| Novacare Rehabilitation of Ohio Inc | Past | Accepting new patients | |
| Crystal Clinic, Inc. | Past | Accepting new patients | |
| Crystal Clinic Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT - 7277 | OH | Yes |
Addresses
Primary practice location
15900 Snow Rd
Suite 500
Brookpark, OH 44142-2859
Mailing address
4262 Windmill CT
Medina, OH 44256-6920
Other providers in Brookpark, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.