Kent Russell Tiv Siady, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

045730 Issued in NY

Practice address

8529 58TH Ave
Elmhurst, NY 11373

Phone

(929) 282-8973

Fax

(718) 218-8878

NPI assigned

Mar 19, 2020

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)

Enrolled

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

{
    "created_epoch": "1584576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1265068407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8529 58TH AVE",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "11373",
            "telephone_number": "929-282-8973",
            "fax_number": "718-218-8878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8529 58TH AVE",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "11373",
            "telephone_number": "929-282-8973",
            "fax_number": "718-218-8878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIADY",
        "first_name": "KENT RUSSELL",
        "middle_name": "TIV",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-19",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "045730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abhishek Kumar Shrinet, MD
• Joel J Shu, M.D.
• Neeraj Shukla, MD
• Chaya Shwaartz, M.D.
• Maya Shyju, FNP
• Jusup Sianturi, MA, LMHC
• Tahamina Kamal Siddique
• Gina Siddiqui, MD
• Harleen Kaur Sidhu
• Jasleen Kaur Sidhu, M.B.,B.S

• Physical Therapist in Elmhurst, NY
• Providers in Elmhurst, 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 19, 2023; 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.