NPIMap

Organization Active NPI

Yad OT PT PLLC

  • Specialist
  • Brooklyn, NY
National Provider Identifier
1174927677
Registry record updated Jan 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
029579 Issued in NY
Legal business name
YAD OT PT PLLC
Practice address
1716 Coney Island Ave
Brooklyn, NY 11230-5801
Phone
(718) 336-4900
NPI assigned
Oct 14, 2014
Last updated
Jan 23, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2015

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

Authorized official

Name
David J Ettinger, PTNPI 1629262993
Title
Managing Member
Phone
(718) 336-4900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 029579 NY Primary

Addresses

Primary practice location

1716 Coney Island Ave
Brooklyn, NY 11230-5801

Mailing address

1565 E 36TH St
Brooklyn, NY 11234-3415
Phone (917) 658-7726

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1413244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421971200000",
    "number": "1174927677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1565 E 36TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112343415",
            "telephone_number": "917-658-7726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1716 CONEY ISLAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112305801",
            "telephone_number": "718-336-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YAD OT PT PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-14",
        "last_updated": "2015-01-23",
        "status": "A",
        "authorized_official_last_name": "ETTINGER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "718-336-4900",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "029579",
            "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 Jan 23, 2015; 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.