New York Physical Therapy Sports Rehabilitation PLLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

0220661 Issued in NY

Legal business name

NEW YORK PHYSICAL THERAPY SPORTS REHABILITATION PLLC

Practice address

4402 Francis Lewis Blvd
Bayside, NY 11361-3041

Phone

(718) 428-7171

Fax

(718) 428-7174

NPI assigned

May 21, 2007

Organization subpart

No

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

Authorized official

Name

Kostas D Koutsoubis, PT

Title

Pres

Phone

(718) 428-7171

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386720000000",
    "number": "1306055959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4402 FRANCIS LEWIS BLVD",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113613041",
            "telephone_number": "718-428-7171",
            "fax_number": "718-428-7174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4402 FRANCIS LEWIS BLVD",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113613041",
            "telephone_number": "718-428-7171",
            "fax_number": "718-428-7174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW YORK PHYSICAL THERAPY SPORTS REHABILITATION PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-21",
        "last_updated": "2013-12-11",
        "status": "A",
        "authorized_official_last_name": "KOUTSOUBIS",
        "authorized_official_first_name": "KOSTAS",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "718-428-7171",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "0220661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• New Standards Physical Therapy, PC
• New York Core Chiropractic P.C.
• New York Dermatology, PC
• New York Dialysis Services, Inc. (Bayside Dialysis Center)
• New York Medical Office Based Surgery PC
• New York Psychological Wellness, PC
• New York Speech-Language Pathology, PLLC
• Norman New, BS,PH
• Kaman NG, M.D.
• Michelle Leong NG, DDS, MS

• Physical Therapist in Bayside, NY
• Providers in Bayside, 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 Dec 11, 2013; 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.