Active NPI
Emiliano Peralta Duran
- Physical Therapist
- Willow Street, PA
National Provider Identifier
1205050242
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT010748L
- Practice address
- 900 Willow Valley Lakes Dr
Willow Street, PA 17584-9663 - Phone
- (717) 464-6861
- NPI assigned
- Apr 12, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT010748L | PA | Primary |
Addresses
Primary practice location
900 Willow Valley Lakes Dr
Willow Street, PA 17584-9663
Mailing address
512 Woodhall Dr
Willow Street, PA 17584-9645
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT010748L | PA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1205050242",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "512 WOODHALL DR",
"city": "WILLOW STREET",
"state": "PA",
"postal_code": "175849645"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 WILLOW VALLEY LAKES DR",
"city": "WILLOW STREET",
"state": "PA",
"postal_code": "175849663",
"telephone_number": "717-464-6861"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DURAN",
"first_name": "EMILIANO",
"middle_name": "PERALTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT010748L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Willow Street, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.