Weston Paxxon PT OT SLP PLLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

028299 Issued in NY

Legal business name

WESTON PAXXON PT OT SLP PLLC

Practice address

3718 Henry Hudson Pkwy # 3726
Suite 1005
Bronx, NY 10463-1502

Phone

(718) 432-1618

Fax

(718) 432-0012

NPI assigned

Jan 12, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Roger R Berkley Jr., PT

Title

Executive VP

Phone

(631) 467-3700

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192147200000",
    "number": "1265582019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 SULLIVAN TRL",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180407958",
            "telephone_number": "610-991-2034",
            "fax_number": "610-438-2046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3718 HENRY HUDSON PKWY # 3726",
            "address_2": "SUITE 1005",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104631502",
            "telephone_number": "718-432-1618",
            "fax_number": "718-432-0012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTON PAXXON PT OT SLP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-12",
        "last_updated": "2007-10-12",
        "status": "A",
        "authorized_official_last_name": "BERKLEY",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "EXECUTIVE VP",
        "authorized_official_telephone_number": "631-467-3700",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "028299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 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.