Dynamic Care OT, PT, SLP PLLC

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

License

021147 Issued in NY

Legal business name

DYNAMIC CARE OT, PT, SLP PLLC

Practice address

7540 Austin St
3GR
Forest Hills, NY 11375-6248

Phone

(718) 286-9212

NPI assigned

Dec 27, 2011

Last updated

May 11, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Jose Davila, PT,MPH

Title

Ceo

Phone

(718) 286-9212

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1324944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368230400000",
    "number": "1194094839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7540 AUSTIN ST",
            "address_2": "3GR",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113756248",
            "telephone_number": "718-286-9212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7540 AUSTIN ST",
            "address_2": "3GR",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113756248",
            "telephone_number": "718-286-9212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC CARE OT, PT, SLP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-27",
        "last_updated": "2013-05-11",
        "status": "A",
        "authorized_official_last_name": "DAVILA",
        "authorized_official_first_name": "JOSE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "718-286-9212",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT,MPH"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NY",
            "license": "021147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2013; 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.