Physico-Connect PT PC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

PHYSICO-CONNECT PT PC

Practice address

189 Burrows LN
Blauvelt, NY 10913-1307

Phone

(646) 944-3923

NPI assigned

May 24, 2023

Organization subpart

No

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

Authorized official

Name

Ahmed Hassanein

Title

Credentialing

Phone

(646) 944-3923

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1684886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684886400000",
    "number": "1336831700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 BURROWS LN",
            "city": "BLAUVELT",
            "state": "NY",
            "postal_code": "109131307",
            "telephone_number": "646-944-3923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "189 BURROWS LN",
            "city": "BLAUVELT",
            "state": "NY",
            "postal_code": "109131307",
            "telephone_number": "646-944-3923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICO-CONNECT PT PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-24",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A",
        "authorized_official_last_name": "HASSANEIN",
        "authorized_official_first_name": "AHMED",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "646-944-3923"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Loryn O'Gorman, RN
• Bernadette O'Shea
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• Kenneth Mark Pardo, DDS
• Andrew Charles Philip, PHD
• Tracey E Polizzi, PH.D.
• Procore Physical Therapy P.C.
• Procore Physical Therapy, P.C.
• Restoredhealth LLC
• Gabriel Ello Reventar, PT

• Physical Medicine & Rehabilitation Physician in Blauvelt, NY
• Providers in Blauvelt, NY by specialty
• Physical Medicine & Rehabilitation Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; 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.