Joseph Wellen Sedrak, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

023838 Issued in NY

Practice address

120 Diamond LN
Old Bridge, NJ 08857-3323

Phone

(201) 888-1549

NPI assigned

Feb 8, 2007

Reactivated

May 18, 2021

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)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Fine Motor Physical Therapy PC

  • Physical Therapist
  • Brooklyn, NY
  • NPI 1396623328
  NPD Authorized official
• C & GL Podiatry Associates, P.C.

  • Foot & Ankle Surgery Podiatrist
  • Brooklyn, NY
  • NPI 1104091859
  NPD (past)
• C&GL Podiatry Associates, P.C.

  • Durable Medical Equipment & Medical Supplies
  • Brooklyn, NY
  • NPI 1356421341
  NPD (past)
• North Austin Medical PC

  • Specialist
  • Forest Hills, NY
  • NPI 1770658627
  NPD (past)

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626998400000",
    "number": "1093856619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 DIAMOND LN",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088573323",
            "telephone_number": "201-888-1549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 DIAMOND LN",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088573323",
            "telephone_number": "201-888-1549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEDRAK",
        "first_name": "JOSEPH",
        "middle_name": "WELLEN",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-08",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "deactivation_date": "2012-10-05",
        "reactivation_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "023838",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "023838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Schmierer, DPM
• Stanley Joel Schnall, M.D.
• Colleen M Schubel, OD
• Naomi S Schwarz, M.D.
• Screen for Life Diagnostic Inc
• Seema Nayyar DO, Inc
• Jennifer Seleem
• Alexis Brynn Sellas, MSW, LCSW
• Vaidya Selvan, BDS,DDS, MAGD
• Sensationall Kids NJ-2 LLC

• Physical Therapist in Old Bridge, NJ
• Providers in Old Bridge, 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 Jul 23, 2021; 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.