Complete Body Physical Therapy 1 PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

026282-1 Issued in NY

Legal business name

COMPLETE BODY PHYSICAL THERAPY 1 PC

Practice address

22 W 19TH St
New York, NY 10011-4204

Phone

(212) 248-3030

Fax

(212) 248-3033

NPI assigned

Mar 3, 2011

Last updated

Mar 3, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Bartosz Nikiciuk, MPT

Title

Clinical Director

Phone

(212) 248-3030

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1299110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299110400000",
    "number": "1265730030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 JOHN ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100382806",
            "telephone_number": "212-248-3030",
            "fax_number": "212-248-3033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 W 19TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100114204",
            "telephone_number": "212-248-3030",
            "fax_number": "212-248-3033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE BODY PHYSICAL THERAPY 1 PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-03",
        "last_updated": "2011-03-03",
        "status": "A",
        "authorized_official_last_name": "NIKICIUK",
        "authorized_official_first_name": "BARTOSZ",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "212-248-3030",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "026282-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in New York, NY
• Providers in New York, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2011; 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.