Lift Bridge Physical Therapy, PLLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

LIFT BRIDGE PHYSICAL THERAPY, PLLC

Practice address

52 Wincanton Dr
Fairport, NY 14450-3847

Phone

(585) 797-5308

NPI assigned

Jul 10, 2022

Organization subpart

No

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

Authorized official

Name

Coleen Riccione, MS PTNPI 1265599252

Title

Owner, Physical Therapist

Phone

(585) 797-5308

Specialties & licenses 2

Addresses

Other identifiers 1

Practitioners 1

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

• Coleen R Riccione, PT

  • Physical Therapist
  • Macedon, NY
  • NPI 1265599252
  NPD Authorized official

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

{
    "created_epoch": "1657411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657411200000",
    "number": "1023742772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 WINCANTON DR",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144503847",
            "telephone_number": "585-797-5308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 WINCANTON DR",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144503847",
            "telephone_number": "585-797-5308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFT BRIDGE PHYSICAL THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-10",
        "last_updated": "2022-07-10",
        "certification_date": "2022-07-10",
        "status": "A",
        "authorized_official_last_name": "RICCIONE",
        "authorized_official_first_name": "COLEEN",
        "authorized_official_title_or_position": "OWNER, PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "585-797-5308",
        "authorized_official_credential": "MS PT"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1265599252",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katrina Johnson Levan, M.S., CAS, NCSP
• Diane P Levin, R.N.
• Esin Lewey, LMHC
• Paula J Lewyckyj
• Sara Liedtke, LMHC
• Linda M Lindsay
• Brendan Michael Linehan, RPH
• Chloe S Linn
• Lisa Marie Chute Optometry PLLC
• Charlene Lochner, BCBA, LBA

• Physical Therapy Clinic/Center in Fairport, NY
• Providers in Fairport, NY by specialty
• Physical Therapy Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2022; 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.