Individual provider Active NPI

Vince Palumbo, PT, DPT

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1053074153
Registry record updated Mar 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
047747 Issued in NY
Practice address
794 Union St
Brooklyn, NY 11215-7583
Phone
(646) 841-1402
NPI assigned
Oct 16, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 047747 NY Primary

Addresses

Primary practice location

794 Union St
Brooklyn, NY 11215-7583

Mailing address

31 E 32ND St FL 4
New York, NY 10016-5595
Phone (732) 666-2257

Other practice location 1

939 68th St Apt C3
Brooklyn, NY 11219-5831
Phone (732) 666-2257

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
047747NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1634342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647907200000",
    "number": "1053074153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 E 32ND ST FL 4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100165595",
            "telephone_number": "732-666-2257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "794 UNION ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112157583",
            "telephone_number": "646-841-1402"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "939 68th St Apt C3",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112195831",
            "country_code": "US",
            "telephone_number": "732-666-2257",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PALUMBO",
        "first_name": "VINCE",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-16",
        "last_updated": "2022-03-22",
        "certification_date": "2022-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "047747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 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.