Soma Vita Physio & Wellness LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

SOMA VITA PHYSIO & WELLNESS LLC

Practice address

775 Mountain Blvd Ste 108
Watchung, NJ 07069-6262

Phone

(516) 591-5544

NPI assigned

Jul 14, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Stella DimitrakakisNPI 1114241718

Title

Physical Therapist / Owner

Phone

(516) 591-5544

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stella Dimitrakakis, DPT

  • Physical Therapist
  • Union, NJ
  • NPI 1114241718
  NPD Authorized official

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

{
    "created_epoch": "1657756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657756800000",
    "number": "1154055143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 OLD STIRLING RD",
            "city": "WARREN",
            "state": "NJ",
            "postal_code": "070595829",
            "telephone_number": "516-591-5544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 MOUNTAIN BLVD STE 108",
            "city": "WATCHUNG",
            "state": "NJ",
            "postal_code": "070696262",
            "telephone_number": "516-591-5544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOMA VITA PHYSIO & WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-14",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A",
        "authorized_official_last_name": "DIMITRAKAKIS",
        "authorized_official_first_name": "STELLA",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST / OWNER",
        "authorized_official_telephone_number": "516-591-5544",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Risa Silverstein
• Isabel Lynn Simpson, LCSW
• Pavel Siutsou, CRNA
• Derrell Sloane
• Mark Slotnick, RPH.
• Marci Hope Sonenblum, LPC
• Amanda Grace Sosunov, MOT, OTR/L
• Ronald Raymond Spiaggia, DC
• Mark T Spratford, DC
• Howard Springer, O.D.

• Physical Therapy Clinic/Center in Watchung, NJ
• Providers in Watchung, NJ by specialty
• Physical Therapy Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2022; 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.