Wading River Physical Therapy, PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

WADING RIVER PHYSICAL THERAPY, PC

Practice address

5958 Route 25a
Wading River, NY 11792-2001

Phone

(631) 929-8200

Fax

(631) 929-8228

NPI assigned

Sep 26, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Walter Paul Vancura, P.T.

Title

Owner/Physical Therapist

Phone

(631) 929-8200

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207008000000",
    "number": "1194826651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5958 ROUTE 25A",
            "city": "WADING RIVER",
            "state": "NY",
            "postal_code": "117922001",
            "telephone_number": "631-929-8200",
            "fax_number": "631-929-8228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5958 ROUTE 25A",
            "city": "WADING RIVER",
            "state": "NY",
            "postal_code": "117922001",
            "telephone_number": "631-929-8200",
            "fax_number": "631-929-8228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WADING RIVER PHYSICAL THERAPY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2008-04-01",
        "status": "A",
        "authorized_official_last_name": "VANCURA",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "631-929-8200",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "N78062",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHILD HEALTH PLUS",
            "identifier": "2N5211",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Wading River, NY
• Providers in Wading River, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2008; 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.