Active NPI
Frailla Mangguray
- Physical Therapist
- Corona, NY
National Provider Identifier
1306198361
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 031204-1
- Practice address
- 100-05 Roosevelt Ave
2ND Floor
Corona, NY 11368 - Phone
- (718) 878-4103
- Fax
- (718) 803-6440
- NPI assigned
- Oct 15, 2012
- Sex
- Female
- 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 | 031204-1 | NY | Primary |
Addresses
Primary practice location
100-05 Roosevelt Ave
2ND Floor
Corona, NY 11368
Mailing address
10005 Roosevelt Ave Apt 2
Corona, NY 11368-4881
Phone (718) 878-4103
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 031204-1 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Active Wellness Physical Therapy P.C. | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapist
- Corona, NY
- NPI 1679826457
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1350259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785974400000",
"number": "1306198361",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10005 ROOSEVELT AVE APT 2",
"city": "CORONA",
"state": "NY",
"postal_code": "113684881",
"telephone_number": "718-878-4103",
"fax_number": "718-803-6440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100-05 ROOSEVELT AVE",
"address_2": "2ND FLOOR",
"city": "CORONA",
"state": "NY",
"postal_code": "11368",
"telephone_number": "718-878-4103",
"fax_number": "718-803-6440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANGGURAY",
"first_name": "FRAILLA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-10-15",
"last_updated": "2026-08-06",
"certification_date": "2026-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "031204-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corona, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.