Lifelink Professionals and Therapy Services, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501006363 Issued in MI

Legal business name

LIFELINK PROFESSIONALS AND THERAPY SERVICES, LLC

Practice address

31201 Chicago Rd S
Suite B-301
Warren, MI 48093-5527

Phone

(586) 722-7000

Fax

(586) 558-9113

NPI assigned

Oct 14, 2016

Organization subpart

No

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

Authorized official

Name

Miss Criselda De Luna, RN, BSN

Title

President

Phone

(586) 722-7000

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1476403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476403200000",
    "number": "1295286201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31201 CHICAGO RD S",
            "address_2": "SUITE B-301",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480935527",
            "telephone_number": "586-722-7000",
            "fax_number": "586-558-9113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31201 CHICAGO RD S",
            "address_2": "SUITE B-301",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480935527",
            "telephone_number": "586-722-7000",
            "fax_number": "586-558-9113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFELINK PROFESSIONALS AND THERAPY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-14",
        "last_updated": "2016-10-14",
        "status": "A",
        "authorized_official_last_name": "DE LUNA",
        "authorized_official_first_name": "CRISELDA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-722-7000",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "RN, BSN"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704179787",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501006363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Peter Lewyckyj, R.PH.
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• Physical Therapist in Warren, MI
• Providers in Warren, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2016; 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.