Active NPI
Cecilia Stanolevich, P.T.
- Pediatric Physical Therapist
- Fresh Meadows, NY
National Provider Identifier
1316192586
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 011068-1
- Practice address
- 6936 169TH St
Fresh Meadows, NY 11365-3325 - Phone
- (718) 591-5649
- NPI assigned
- Dec 1, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 011068-1 | NY | Primary |
Addresses
Primary practice location
6936 169TH St
Fresh Meadows, NY 11365-3325
Mailing address
6936 169TH St
Fresh Meadows, NY 11365-3325
Phone (718) 591-5649
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 |
|---|---|---|---|
| 011068-1 | NY | MD | Pediatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1228089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1228089600000",
"number": "1316192586",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6936 169TH ST",
"city": "FRESH MEADOWS",
"state": "NY",
"postal_code": "113653325",
"telephone_number": "718-591-5649"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6936 169TH ST",
"city": "FRESH MEADOWS",
"state": "NY",
"postal_code": "113653325",
"telephone_number": "718-591-5649"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STANOLEVICH",
"first_name": "CECILIA",
"name_prefix": "Mrs.",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-12-01",
"last_updated": "2008-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "NY",
"license": "011068-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fresh Meadows, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.