Union Street Physical Therapy,PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

016905-1 Issued in NY

Legal business name

UNION STREET PHYSICAL THERAPY,PC

Practice address

3125 Union St
Flushing, NY 11354-2346

Phone

(718) 445-6339

Fax

(718) 445-6933

NPI assigned

Oct 2, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Vincent Emil Doctor III, PT

Title

Owner

Phone

(718) 445-6339

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174616031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3125 UNION ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113542346",
            "telephone_number": "718-445-6339",
            "fax_number": "718-445-6933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3125 UNION ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113542346",
            "telephone_number": "718-445-6339",
            "fax_number": "718-445-6933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNION STREET PHYSICAL THERAPY,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DOCTOR",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_middle_name": "EMIL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-445-6339",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "016905-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Flushing, NY
• Providers in Flushing, NY by specialty
• Physical Therapist in New York

• 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.