Individual provider Active NPI

Heba Waly, DPT

  • Physical Therapy Clinic/Center
  • Brooklyn, NY
National Provider Identifier
1194513010
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
053503 Issued in NY
Practice address
3063 Brighton 8TH St Ste 3
Brooklyn, NY 11235-6593
Phone
(818) 535-1549
NPI assigned
Apr 29, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 053503 NY Primary

Addresses

Primary practice location

3063 Brighton 8TH St Ste 3
Brooklyn, NY 11235-6593

Mailing address

221 Father Capodanno Blvd # 1
Staten Island, NY 10305-4202

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
053503NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1745884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1194513010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 FATHER CAPODANNO BLVD # 1",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103054202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3063 BRIGHTON 8TH ST STE 3",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112356593",
            "telephone_number": "818-535-1549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALY",
        "first_name": "HEBA",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-29",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NY",
            "license": "053503",
            "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 Apr 29, 2025; 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.