Organization Active NPI

Roger W. Herbowy, PT

  • Physical Therapy Clinic/Center
  • Utica, NY
National Provider Identifier
1336536671
Registry record updated Apr 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
012286-1 Issued in NY
Legal business name
ROGER W. HERBOWY, PT
Practice address
2516 Genesee St
Utica, NY 13502-5814
Phone
(315) 735-2728
Fax
(315) 735-7820
NPI assigned
Apr 24, 2015
Last updated
Apr 24, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2015

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

Authorized official

Name
Mrs. Kristin Marie McCully, O.T.
Title
Occupational Theraoist
Phone
(315) 735-2728

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 012286-1 NY Primary

Addresses

Primary practice location

2516 Genesee St
Utica, NY 13502-5814

Mailing address

2516 Genesee St
Utica, NY 13502-5814
Phone (315) 735-2728

National Provider Directory

National Provider Directory

Locations

2516 Genesee St
Utica, NY 13502
Phone (315) 735-2728

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1429833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429833600000",
    "number": "1336536671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2516 GENESEE ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135025814",
            "telephone_number": "315-735-2728",
            "fax_number": "315-735-7820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2516 GENESEE ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135025814",
            "telephone_number": "315-735-2728",
            "fax_number": "315-735-7820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROGER W. HERBOWY, PT",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-24",
        "last_updated": "2015-04-24",
        "status": "A",
        "authorized_official_last_name": "MCCULLY",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAOIST",
        "authorized_official_telephone_number": "315-735-2728",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "O.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NY",
            "license": "012286-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Utica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2015; 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.