Active NPI
Brian Perez, P.T.A
- Physical Disabilities Residential Treatment Facility
- Richmond Hill, NY
National Provider Identifier
1205114048
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Disabilities Residential Treatment Facility
- License
- 006152-1
- Practice address
- 8776 117TH St
Richmond Hill, NY 11418-2428 - Phone
- (917) 545-1566
- NPI assigned
- Jul 27, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 Disabilities Residential Treatment Facility | 320700000X | 006152-1 | NY | Primary |
Addresses
Primary practice location
8776 117TH St
Richmond Hill, NY 11418-2428
Mailing address
8776 117TH St
Richmond Hill, NY 11418-2428
Phone (917) 545-1566
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 |
|---|---|---|---|
| 006152-1 | NY | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311724800000",
"number": "1205114048",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8776 117TH ST",
"city": "RICHMOND HILL",
"state": "NY",
"postal_code": "114182428",
"telephone_number": "917-545-1566"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8776 117TH ST",
"city": "RICHMOND HILL",
"state": "NY",
"postal_code": "114182428",
"telephone_number": "917-545-1566"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ",
"first_name": "BRIAN",
"credential": "P.T.A",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-07-27",
"last_updated": "2011-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "320700000X",
"taxonomy_group": "",
"desc": "Residential Treatment Facility, Physical Disabilities",
"state": "NY",
"license": "006152-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richmond Hill, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.