NPIMap

Organization Active NPI

PRN Physical, Occupational and Speech Therapy Network, PLLC

  • Physical Therapist
  • East Greenbush, NY
National Provider Identifier
1336185263
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
003194-1 Issued in NY
Legal business name
PRN PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY NETWORK, PLLC
Practice address
30 Community Way
East Greenbush, NY 12061-3925
Phone
(518) 410-6605
NPI assigned
Jun 21, 2006
Last updated
Feb 28, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Susan Roach
Title
Practice Manager
Phone
(631) 467-3700

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 003194-1 NY Primary
Hand Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XH1200X 007731-1 NY
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X 014049 NY

Addresses

Primary practice location

30 Community Way
East Greenbush, NY 12061-3925

Mailing address

2222 Sullivan TRL
Easton, PA 18040-7958
Phone (610) 438-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051012000029 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 5092730788 Receives reassigned benefits from 91 practitioners
Practice locations: Mount Sinai, NY; North Hills, NY; Orchard Park, NY; Queensbury, NY; Rochester, NY; Saratoga Springs, NY; Schenectady, NY; Slingerlands, NY…

National Provider Directory

National Provider Directory

Locations

345 Northern Blvd
#100
Albany, NY 12204

345 Northern Blvd
Ste 100
Albany, NY 12204
Phone (518) 462-1689

9570 Transit Rd
East Amherst, NY 14051
Phone (716) 688-5709

9570 Transit Rd
Ste 2
East Amherst, NY 14051
Phone (716) 688-5709

40 Merrick Ave
Ste 1
East Meadow, NY 11554
Phone (516) 542-0800

20 Peachtree Ct
Holbrook, NY 11741

1 Bella Vista Dr
Ithaca, NY 14850
Phone (607) 375-6300

150 Old Liverpool Rd
Ofc
Liverpool, NY 13088

1 Eastwyck Cir
Rensselaer, NY 12144
Phone (518) 371-5554

11701 84th Ave
Ste 915
Richmond Hill, NY 11418
Phone (718) 286-3877

1 Treeline Dr
Rochester, NY 14612

4701 Peregrine Way
Syracuse, NY 13215

2218 Burdett Ave
Troy, NY 12180
Phone (518) 788-7157

1715 Castle Gardens Rd
Vestal, NY 13850
Phone (607) 484-5079

2821 Wehrle Dr
Williamsville, NY 14221
Phone (716) 908-6374

2821 Wehrle Dr
Ste 10
Williamsville, NY 14221
Phone (716) 688-5709

2222 Sullivan Trl
Ste 105
Easton, PA 18040
Phone (574) 261-7058

Practitioners & affiliated clinicians

Practitioners 116

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 116

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709078400000",
    "number": "1336185263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 SULLIVAN TRL",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180407958",
            "telephone_number": "610-438-2020",
            "fax_number": "631-467-0928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 COMMUNITY WAY",
            "city": "EAST GREENBUSH",
            "state": "NY",
            "postal_code": "120613925",
            "telephone_number": "518-410-6605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRN PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY NETWORK, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-21",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A",
        "authorized_official_last_name": "ROACH",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "631-467-3700"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "003194-1",
            "primary": true
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Hand",
            "state": "NY",
            "license": "007731-1",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "014049",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Greenbush, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.