Individual provider Active NPI

Brian Michael Palomba, PT, DPT

  • Physical Therapist
  • New York, NY
National Provider Identifier
1184020661
Registry record updated Nov 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
039374 Issued in NY
Practice address
89 5TH Ave
Suite 1002
New York, NY 10003-3020
Phone
(212) 255-6355
NPI assigned
Nov 11, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 039374 NY Primary

Addresses

Primary practice location

89 5TH Ave
Suite 1002
New York, NY 10003-3020

Mailing address

791 9TH Ave
Apt 5R
New York, NY 10019-5643
Phone (586) 524-9632

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1415664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446681600000",
    "number": "1184020661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "791 9TH AVE",
            "address_2": "APT 5R",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100195643",
            "telephone_number": "586-524-9632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 5TH AVE",
            "address_2": "SUITE 1002",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033020",
            "telephone_number": "212-255-6355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALOMBA",
        "first_name": "BRIAN",
        "middle_name": "MICHAEL",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-11",
        "last_updated": "2015-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "039374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.