Individual provider Active NPI

Lilly Rawlyk, PT

  • Specialist
  • Poughkeepsie, NY
National Provider Identifier
1255439790
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
008377-0 Issued in NY
Practice address
201 South Ave
Suite 501
Poughkeepsie, NY 12601-4812
Phone
(845) 475-5668
Fax
(845) 473-6048
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 008377-0 NY Primary

Addresses

Primary practice location

201 South Ave
Suite 501
Poughkeepsie, NY 12601-4812

Mailing address

5 Arden LN
New Paltz, NY 12561-3501
Phone (845) 255-3409

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
008377-0NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1255439790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 ARDEN LN",
            "city": "NEW PALTZ",
            "state": "NY",
            "postal_code": "125613501",
            "telephone_number": "845-255-3409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 SOUTH AVE",
            "address_2": "SUITE 501",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126014812",
            "telephone_number": "845-475-5668",
            "fax_number": "845-473-6048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAWLYK",
        "first_name": "LILLY",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "008377-0",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.