Individual provider Active NPI

Shayna Haley, PTA

  • Physical Therapy Assistant
  • New York, NY
National Provider Identifier
1215108311
Registry record updated Mar 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
006825-1 Issued in NY
Practice address
77 Mercer St
Lower Level
New York, NY 10012-4460
Phone
(212) 226-6704
Fax
(212) 226-8207
NPI assigned
Mar 17, 2008
Last updated
Mar 17, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 006825-1 NY Primary

Addresses

Primary practice location

77 Mercer St
Lower Level
New York, NY 10012-4460

Mailing address

77 Mercer St
Lower Level
New York, NY 10012-4460
Phone (212) 226-6704

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
006825-1NYMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1205712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205712000000",
    "number": "1215108311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 MERCER ST",
            "address_2": "LOWER LEVEL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100124460",
            "telephone_number": "212-226-6704",
            "fax_number": "212-226-8207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 MERCER ST",
            "address_2": "LOWER LEVEL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100124460",
            "telephone_number": "212-226-6704",
            "fax_number": "212-226-8207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALEY",
        "first_name": "SHAYNA",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-17",
        "last_updated": "2008-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "006825-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.