Haven Mobility

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

HAVEN MOBILITY

Practice address

3136 State Route 207 Ste 202
Campbell Hall, NY 10916-2234

Phone

(845) 202-0554

Fax

(845) 615-9189

NPI assigned

Apr 12, 2022

Organization subpart

No

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

Authorized official

Name

Shibayia Mitchell

Title

Credentialing Manager

Phone

(347) 755-3653

Specialties & licenses 1

Addresses

Other names 1

• Haven Mobility Doing business as

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1649721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649721600000",
    "number": "1164164992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3136 STATE ROUTE 207 STE 202",
            "city": "CAMPBELL HALL",
            "state": "NY",
            "postal_code": "109162234",
            "telephone_number": "845-202-0554",
            "fax_number": "845-615-9189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3136 STATE ROUTE 207 STE 202",
            "city": "CAMPBELL HALL",
            "state": "NY",
            "postal_code": "109162234",
            "telephone_number": "845-202-0554",
            "fax_number": "845-615-9189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVEN MOBILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-12",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "SHIBAYIA",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "347-755-3653"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Thehavenmobility@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Thehavenmobility@gmail.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3136 State Route 207 Ste 202",
            "city": "Campbell Hall",
            "state": "NY",
            "country_code": "US",
            "postal_code": "109162234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Haven Mobility",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mei PO Chin Flynn, DPT
• Mary Jo Gallagher
• Elizabeth A. Grimaldi, R.D.
• Paul David Hand
• Jamie R. Hatzis, PH.D., LCSW
• Lauren Mara Incontrera, RN
• Nicholas Iorio, LMSW
• Latonya James
• Kaitlin Joy Kelly
• Jacquelyn Klein, MS

• Physical Therapy Clinic/Center in Campbell Hall, NY
• Providers in Campbell Hall, NY by specialty
• Physical Therapy Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 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.