Dynamic Rehab PT, PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

0292741 Issued in NY

Legal business name

DYNAMIC REHAB PT, PC

Practice address

316 N 6TH St
Prospect Park, NJ 07508-2122

Phone

(973) 910-0307

Fax

(718) 233-2570

NPI assigned

Jul 19, 2010

Organization subpart

No

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

Authorized official

Name

Anatoli Yoshovayev, DPT

Title

Physical Therapist

Phone

(917) 977-0096

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1279497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279497600000",
    "number": "1245543255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8502 139TH ST APT 3E",
            "city": "BRIARWOOD",
            "state": "NY",
            "postal_code": "114352649",
            "telephone_number": "917-977-0096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 N 6TH ST",
            "city": "PROSPECT PARK",
            "state": "NJ",
            "postal_code": "075082122",
            "telephone_number": "973-910-0307",
            "fax_number": "718-233-2570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC REHAB PT, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-19",
        "last_updated": "2010-07-19",
        "status": "A",
        "authorized_official_last_name": "YOSHOVAYEV",
        "authorized_official_first_name": "ANATOLI",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "917-977-0096",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "0292741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Prospect Park, NJ
• Providers in Prospect Park, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2010; 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.