NPIMap

Organization Active NPI

Phoenix Physical Therapy Services, P.C.

  • Orthopedic Physical Therapist
  • Amherst, NY
National Provider Identifier
1053553578
Registry record updated Mar 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
028030 Issued in NY
Legal business name
PHOENIX PHYSICAL THERAPY SERVICES, P.C.
Practice address
4498 Main Street
Suite #24
Amherst, NY 14226
Phone
(716) 839-1550
Fax
(716) 839-1696
NPI assigned
Mar 30, 2009
Last updated
Mar 30, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2009

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

Authorized official

Name
Mrs. Laura M Favaro, PTNPI 1528113800
Title
Owner, Physical Therapist
Phone
(716) 839-1550

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 2251X0800X 028030 NY Primary

Addresses

Primary practice location

4498 Main Street
Suite #24
Amherst, NY 14226

Mailing address

171 Darwin Drive
Amherst, NY 14226
Phone (716) 839-1550

Other names 1

  • Phoenix Physical Therapy Other name

National Provider Directory

National Provider Directory

Locations

4498 Main St
Ste 24
Buffalo, NY 14226
Phone (716) 839-1550

4498 Main St
Snyder, NY 14226
Phone (716) 839-1550

Practitioners & affiliated clinicians

Practitioners 27

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1238371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238371200000",
    "number": "1053553578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 DARWIN DRIVE",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "14226",
            "telephone_number": "716-839-1550",
            "fax_number": "716-839-1696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4498 MAIN STREET",
            "address_2": "SUITE #24",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "14226",
            "telephone_number": "716-839-1550",
            "fax_number": "716-839-1696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX PHYSICAL THERAPY SERVICES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-30",
        "last_updated": "2009-03-30",
        "status": "A",
        "authorized_official_last_name": "FAVARO",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER, PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "716-839-1550",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NY",
            "license": "028030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phoenix Physical Therapy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Amherst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2009; 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.