Lisa Brez, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

010656-1 Issued in NY

Practice address

1315 Gateway Blvd Apt 2L
Far Rockaway, NY 11691-5245

Phone

(201) 925-8159

NPI assigned

Nov 14, 2024

Last updated

Nov 14, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1731542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1316761497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 GATEWAY BLVD APT 2L",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116915245",
            "telephone_number": "201-925-8159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 GATEWAY BLVD APT 2L",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116915245",
            "telephone_number": "201-925-8159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREZ",
        "first_name": "LISA",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-14",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "010656-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Assistant in Far Rockaway, NY
• Providers in Far Rockaway, NY by specialty
• Physical Therapy Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; 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.