Individual provider Active NPI

Freudelyne St Surin

  • Physical Therapy Assistant
  • Brooklyn, NY
National Provider Identifier
1154858066
Registry record updated May 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
008445 Issued in NY
Practice address
840 Lefferts Ave # a
Brooklyn, NY 11203-1301
Phone
(718) 778-8587
NPI assigned
May 23, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 008445 NY Primary

Addresses

Primary practice location

840 Lefferts Ave # a
Brooklyn, NY 11203-1301

Mailing address

2501 Nostrand Ave Apt 4M
Brooklyn, NY 11210-4709
Phone (718) 483-3262

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
008445NYMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1495497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495497600000",
    "number": "1154858066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 NOSTRAND AVE APT 4M",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112104709",
            "telephone_number": "718-483-3262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 LEFFERTS AVE # A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112031301",
            "telephone_number": "718-778-8587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST SURIN",
        "first_name": "FREUDELYNE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-23",
        "last_updated": "2017-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "008445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2017; 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.