Periphon D Faustino, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA00810200 Issued in NJ

Practice address

375 McCarter Hwy
Newark, NJ 07114

Phone

(973) 643-8601

Fax

(973) 643-8609

NPI assigned

Mar 27, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1083732796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 MCCARTER HWY",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071142562",
            "telephone_number": "973-643-8601",
            "fax_number": "973-643-8609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 MCCARTER HWY",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "07114",
            "telephone_number": "973-643-8601",
            "fax_number": "973-643-8609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAUSTINO",
        "first_name": "PERIPHON",
        "middle_name": "D",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT6503",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00810200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hamida Farzana, RPH
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• Musa Fatai
• Jessica Marie Fatale
• Alessandra Faverio, MD
• Patricia Anne Fay, PT, DPT
• Fayez Shamoon
• Anthony Fazio, PHARMD
• Adam Jeffrey Fechner, M.D.

• Physical Therapist in Newark, NJ
• Providers in Newark, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2019; 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.