Active NPI
Marisa Anne Persichilli, P.T., D.P.T.
- Physical Therapist
- Saint James, NY
National Provider Identifier
1033586987
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 035658-1
- Practice address
- 290 2ND Ave
Saint James, NY 11780-2350 - Phone
- (631) 232-0426
- NPI assigned
- Aug 26, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 035658-1 | NY | Primary |
Addresses
Primary practice location
290 2ND Ave
Saint James, NY 11780-2350
Mailing address
290 2ND Ave
Saint James, NY 11780-2350
Phone (631) 232-0426
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
| License | State | Type | Specialty |
|---|---|---|---|
| 035658-1 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440547200000",
"number": "1033586987",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "290 2ND AVE",
"city": "SAINT JAMES",
"state": "NY",
"postal_code": "117802350",
"telephone_number": "631-232-0426"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "290 2ND AVE",
"city": "SAINT JAMES",
"state": "NY",
"postal_code": "117802350",
"telephone_number": "631-232-0426"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERSICHILLI",
"first_name": "MARISA",
"middle_name": "ANNE",
"name_prefix": "Miss",
"credential": "P.T., D.P.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-08-26",
"last_updated": "2015-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "035658-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint James, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.