Active NPI
Manu Abraham Alex, PT
- Physical Therapist
- Staten Island, NY
National Provider Identifier
1265763452
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 030010-1
- Practice address
- 361 Edison St
Staten Island, NY 10306-3043 - Phone
- (718) 980-0101
- Fax
- (718) 980-1641
- NPI assigned
- Jan 27, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 030010-1 | NY | Primary |
Addresses
Primary practice location
361 Edison St
Staten Island, NY 10306-3043
Mailing address
361 Edison St
Staten Island, NY 10306-3043
Phone (718) 980-0101
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240530000506 | NY | Practitioner - Physical Therapist in Private Practice | 6608218011 | Practice locations: Staten Island, NY |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 030010 | NY | MD | Dentist |
| 030010-1 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1264550400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1264550400000",
"number": "1265763452",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "361 EDISON ST",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103063043",
"telephone_number": "718-980-0101",
"fax_number": "718-980-1641"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "361 EDISON ST",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103063043",
"telephone_number": "718-980-0101",
"fax_number": "718-980-1641"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALEX",
"first_name": "MANU",
"middle_name": "ABRAHAM",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-01-27",
"last_updated": "2010-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "030010-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2010; 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.