Paul Henry Vazquez, M.S., P.T.

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

018893-1 Issued in NY

Practice address

457 Clay Pitts Rd
East Northport, NY 11731-3821

Phone

(631) 486-8572

Fax

(631) 368-4975

NPI assigned

Jan 28, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1169942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124174396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "457 CLAY PITTS RD",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117313821",
            "telephone_number": "631-486-8572",
            "fax_number": "631-368-4975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "457 CLAY PITTS RD",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117313821",
            "telephone_number": "631-486-8572",
            "fax_number": "631-368-4975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ",
        "first_name": "PAUL",
        "middle_name": "HENRY",
        "credential": "M.S., P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NY",
            "license": "018893-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Physical Therapist in East Northport, NY
• Providers in East Northport, NY by specialty
• Pediatric Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.