Active NPI
Petya C Yaneva, PT
- Physical Therapist
- Lakewood, NJ
National Provider Identifier
1326331265
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 021032
- Practice address
- 685 River Ave
Lakewood, NJ 08701-5288 - Phone
- (215) 968-4650
- NPI assigned
- May 25, 2011
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 021032 | PA | Primary |
Addresses
Primary practice location
685 River Ave
Lakewood, NJ 08701-5288
Mailing address
1702 Robin Dr
Bensalem, PA 19020-4415
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 021032 | PA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1306281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1575590400000",
"number": "1326331265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1702 ROBIN DR",
"city": "BENSALEM",
"state": "PA",
"postal_code": "190204415"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "685 RIVER AVE",
"city": "LAKEWOOD",
"state": "NJ",
"postal_code": "087015288",
"telephone_number": "215-968-4650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YANEVA",
"first_name": "PETYA",
"middle_name": "C",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-05-25",
"last_updated": "2019-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "021032",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakewood, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.