Active NPI
Vladislav Podolski, PT, MBA
- Physical Therapist
- Brooklyn, NY
National Provider Identifier
1316958937
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 022074
- Practice address
- 585 Schenectady Avenue
Brooklyn, NY 11203 - Phone
- (718) 604-5000
- NPI assigned
- Aug 10, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 022074 | NY | Primary |
Addresses
Primary practice location
585 Schenectady Avenue
Brooklyn, NY 11203
Mailing address
585 Schenectady Avenue
Brooklyn, NY 11203
Phone (718) 604-5000
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
- Credentials
- Master of Business Administration
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 022074 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343260800000",
"number": "1316958937",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "585 SCHENECTADY AVENUE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "11203",
"telephone_number": "718-604-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "585 SCHENECTADY AVENUE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "11203",
"telephone_number": "718-604-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PODOLSKI",
"first_name": "VLADISLAV",
"credential": "PT, MBA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-10",
"last_updated": "2012-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "022074",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.