Raphael Bolanos

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01382600 Issued in NJ

Practice address

315 5TH Ave
Suite 806
New York, NY 10016-6510

Phone

(212) 686-8881

NPI assigned

Jun 14, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1308009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308009600000",
    "number": "1225323629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "913 BOULEVARD",
            "address_2": "APARTMENT A",
            "city": "NEW MILFORD",
            "state": "NJ",
            "postal_code": "076466416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 5TH AVE",
            "address_2": "SUITE 806",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166510",
            "telephone_number": "212-686-8881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLANOS",
        "first_name": "RAPHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-14",
        "last_updated": "2011-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01382600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oneil Boland, LPN
• Patrick J Boland, MD
• Thomas B Boland, PH.D.
• William M. Boland, CES, NPRT, CPT
• Maria L Bolanos-Tamayo, LCSW
• Candice Bolbach, LMSW
• India Trotter Bolcome, LICSW
• Bold Brown Mental Health Counseling PLLC
• Dina Bolden, N.P.
• Wanda Ramona Bolden, LMHC

• Physical Therapist in New York, NY
• Providers in New York, 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 Jun 14, 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.

Verify at the official NPI Registry.