NPIMap

Organization Active NPI

Fun Fitness Physical Therapy PC

  • Physical Therapist
  • Jamaica, NY
National Provider Identifier
1124172804
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
017273 Issued in NY
Legal business name
FUN FITNESS PHYSICAL THERAPY PC
Practice address
8014 170TH St
Jamaica, NY 11432-1331
Phone
(212) 674-4616
NPI assigned
Jan 22, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Deborah Goetz
Title
President
Phone
(212) 674-4616

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X 017273 NY Primary

Addresses

Primary practice location

8014 170TH St
Jamaica, NY 11432-1331

Mailing address

8014 170TH St
Jamaica, NY 11432-1331

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 16

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 16

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124172804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8014 170TH ST",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114321331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8014 170TH ST",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114321331",
            "telephone_number": "212-674-4616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUN FITNESS PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GOETZ",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-674-4616"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "017273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 22, 2020; 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.