GJ, Physical Therapist

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

License

019910-1 Issued in NY

Legal business name

GJ, PHYSICAL THERAPIST

Practice address

1822 Corporal Kennedy St
Bayside, NY 11360-1447

Phone

(646) 417-1300

NPI assigned

Aug 27, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Gholamreza Jahanara, DR OF PHYSICAL THERANPI 1164671947

Title

President

Phone

(646) 417-1300

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gholamreza Jahanara, DR PHYSICALTHERAPY

  • Pediatric Physical Therapist
  • Bayside, NY
  • NPI 1164671947
  NPD (past) Authorized official

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

{
    "created_epoch": "1440633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440633600000",
    "number": "1184091068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18-22 CORPORAL KENNEDY STREET",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "11360",
            "telephone_number": "646-417-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1822 CORPORAL KENNEDY ST",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113601447",
            "telephone_number": "646-417-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GJ, PHYSICAL THERAPIST",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-27",
        "last_updated": "2015-08-27",
        "status": "A",
        "authorized_official_last_name": "JAHANARA",
        "authorized_official_first_name": "GHOLAMREZA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "646-417-1300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DR OF PHYSICAL THERA"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NY",
            "license": "019910-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara Anne Gilliard, LMSW
• Sooyeon Gim, DC
• Angela Giraldo
• Omaira Luz Giraldo
• David Gitlin, DPM
• Eleni Artemis Glikakis
• Rosa Lee Goglas, DPT
• Alan David Gold, D.D.S.
• Samantha Golden-Espinal, MD
• Olga Goldenberg, FNP

• Early Intervention Provider Agency in Bayside, NY
• Providers in Bayside, NY by specialty
• Early Intervention Provider Agency in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.