NPIMap

Organization Active NPI

Reverb Physical Therapy PC

  • Physical Therapist
  • Jamaica, NY
National Provider Identifier
1073717542
Registry record updated Aug 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
023615 Issued in NY
Legal business name
REVERB PHYSICAL THERAPY PC
Practice address
17013 Hillside Ave
Jamaica, NY 11432-4546
Phone
(718) 805-6537
NPI assigned
Jun 11, 2007
Last updated
Aug 10, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2007

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

Authorized official

Name
Kennedy Naguit Reyes, PTNPI 1265528814
Title
President
Phone
(718) 805-6537

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 023615 NY Primary

Addresses

Primary practice location

17013 Hillside Ave
Jamaica, NY 11432-4546

Mailing address

9049 Silver Rd
Ozone Park, NY 11417-2050
Phone (718) 805-6537

Other names 1

  • Reverb PT PC Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186704000000",
    "number": "1073717542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9049 SILVER RD",
            "city": "OZONE PARK",
            "state": "NY",
            "postal_code": "114172050",
            "telephone_number": "718-805-6537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17013 HILLSIDE AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114324546",
            "telephone_number": "718-805-6537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVERB PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-11",
        "last_updated": "2007-08-10",
        "status": "A",
        "authorized_official_last_name": "REYES",
        "authorized_official_first_name": "KENNEDY",
        "authorized_official_middle_name": "NAGUIT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-805-6537",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "023615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Reverb PT PC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jamaica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2007; 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.