Dexter Fajardo Delima, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

029139 Issued in NY

Practice address

6504 Booth St Apt 3C
Rego Park, NY 11374-4026

Phone

(646) 203-3623

NPI assigned

Jun 16, 2010

Last updated

Jun 16, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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": "1276646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276646400000",
    "number": "1285955914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6504 BOOTH ST APT 3C",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113744026",
            "telephone_number": "646-203-3623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6504 BOOTH ST APT 3C",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113744026",
            "telephone_number": "646-203-3623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELIMA",
        "first_name": "DEXTER",
        "middle_name": "FAJARDO",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-16",
        "last_updated": "2010-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "029139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Rego Park, NY
• Providers in Rego Park, 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 16, 2010; 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.