Dileep Kumar Pallattu Vasudeva Panicker, PHYSICAL THERAPIST

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

033293 Issued in NY

Practice address

247 12B 76TH Ave
Bellerose, NY 11426-1879

Phone

(845) 453-4439

NPI assigned

Nov 21, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1668988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1336858141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "247 12B 76TH AVE",
            "city": "BELLEROSE",
            "state": "NY",
            "postal_code": "114261879",
            "telephone_number": "845-453-4439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "247 12B 76TH AVE",
            "city": "BELLEROSE",
            "state": "NY",
            "postal_code": "114261879",
            "telephone_number": "845-453-4439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALLATTU VASUDEVA PANICKER",
        "first_name": "DILEEP",
        "middle_name": "KUMAR",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-11-21",
        "last_updated": "2022-11-21",
        "certification_date": "2022-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "033293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christianah Yetunde Ogunlesi, MD
• Amenaghawon Ojigbede
• Emmanuel Kay Olubiyi, FNP-BC
• Nicole Ortiz
• Mary Ann Paguio
• Pallavi Patel OT P.C
• Olga Nadine Papagianopoulos, PHARMD
• Manpreet Parhar
• Kelly Paskor, OTR/L
• Patel Medical Care P.C.

• Physical Therapist in Bellerose, NY
• Providers in Bellerose, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2022; 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.