Individual provider Active NPI

Audrey Longid Gulian, PHYSICAL THERAPIST

  • Physical Therapist
  • Valley Stream, NY
National Provider Identifier
1265629497
Registry record updated Jun 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
014692-1 Issued in NY
Practice address
57 Brook Rd
Valley Stream, NY 11581-2419
Phone
(718) 275-3661
Fax
(516) 568-7912
NPI assigned
Oct 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 014692-1 NY Primary

Addresses

Primary practice location

57 Brook Rd
Valley Stream, NY 11581-2419

Mailing address

57 Brook Rd
Valley Stream, NY 11581-2419
Phone (718) 275-3661

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040308000002 NY Practitioner - Physical Therapist in Private Practice 9830087329 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
014592NYMDPsychologist
014692-1NYMDOccupational Therapist
014692NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Epic Long Island CurrentSince Feb 12, 2013 Accepting new patients
Epic Medical Services PC CurrentSince Apr 1, 2016 Accepting new patients
Epilepsy Foundation of L.I. CurrentSince Feb 12, 2013 Accepting new patients

Locations

1500 Hempstead Tpke
East Meadow, NY 11554
Phone 51673977331420

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1191283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243814400000",
    "number": "1265629497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 BROOK RD",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115812419",
            "telephone_number": "718-275-3661",
            "fax_number": "516-568-7912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 BROOK RD",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115812419",
            "telephone_number": "718-275-3661",
            "fax_number": "516-568-7912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULIAN",
        "first_name": "AUDREY",
        "middle_name": "LONGID",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-02",
        "last_updated": "2009-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "014692-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.