Active NPI
Lolita Divilova
- Physical Therapist
- Brooklyn, NY
National Provider Identifier
1053769729
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 019708-1
- Practice address
- 1545 Atlantic Ave
Brooklyn, NY 11213-1122 - Phone
- (718) 613-7114
- NPI assigned
- Jun 2, 2016
- Sex
- Female
- Sole proprietor
- No
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 | 019708-1 | NY | Primary |
Addresses
Primary practice location
1545 Atlantic Ave
Brooklyn, NY 11213-1122
Mailing address
1545 Atlantic Ave
Brooklyn, NY 11213-1122
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 |
|---|---|---|---|
| 019708-1 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464825600000",
"number": "1053769729",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1545 ATLANTIC AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112131122"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1545 ATLANTIC AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112131122",
"telephone_number": "718-613-7114"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIVILOVA",
"first_name": "LOLITA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-02",
"last_updated": "2016-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "019708-1",
"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 Jun 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.