Lacey Jaymes Rezucha, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

045963-01 Issued in NY

Practice address

153 Oakdale Rd Ste 2
Johnson City, NY 13790-1007

Phone

(607) 217-0825

Fax

(607) 217-0829

NPI assigned

Nov 12, 2020

Sex

Female

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)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Physical Therapy at Oakdale

  • Physical Therapist
  • Johnson City, NY
  • NPI 1073554788
  NPD

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

{
    "created_epoch": "1605139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605139200000",
    "number": "1255933479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 OAKDALE RD STE 2",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137901007",
            "telephone_number": "607-217-0825",
            "fax_number": "607-217-0829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 OAKDALE RD STE 2",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137901007",
            "telephone_number": "607-217-0825",
            "fax_number": "607-217-0829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REZUCHA",
        "first_name": "LACEY",
        "middle_name": "JAYMES",
        "name_prefix": "Miss",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-12",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "045963-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sherri A Reed, RD
• Afzal Ur Rehman, MD, PHD.
• Bethany Reinhard, FNP
• Kaylyn Reyner, OT
• Ellen Patricia Reynolds, PCNP
• Sarah Lynn Richeda, NP
• Richard M Rigotti, MD
• Makayla Rinker
• Brittany Riso, LMSW
• Francis J Riso

• Physical Therapist in Johnson City, NY
• Providers in Johnson City, 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 Nov 12, 2020; 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.