NPIMap

Organization Active NPI

Professional Orthopedic and Sports Physical Therapy PC

  • Physical Therapist
  • New York, NY
National Provider Identifier
1235549452
Registry record updated Mar 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY PC
Practice address
552 Broadway
4TH Floor
New York, NY 10012-3922
Phone
(212) 226-6704
Fax
(212) 226-8207
NPI assigned
Apr 28, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2018

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

Authorized official

Name
Leticia Pabellon
Title
VP of Administrative Operations
Phone
(516) 321-2447

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

552 Broadway
4TH Floor
New York, NY 10012-3922

Mailing address

576 Broadhollow Rd
Melville, NY 11747-5002
Phone (212) 226-6704

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1398643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522281600000",
    "number": "1235549452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 BROADHOLLOW RD",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117475002",
            "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": "552 BROADWAY",
            "address_2": "4TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100123922",
            "telephone_number": "212-226-6704",
            "fax_number": "212-226-8207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-28",
        "last_updated": "2018-03-29",
        "status": "A",
        "authorized_official_last_name": "PABELLON",
        "authorized_official_first_name": "LETICIA",
        "authorized_official_title_or_position": "VP OF ADMINISTRATIVE OPERATIONS",
        "authorized_official_telephone_number": "516-321-2447"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "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 29, 2018; 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.