Maplewood Physical Therapy PLLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

MAPLEWOOD PHYSICAL THERAPY PLLC

Practice address

205 State Street Rd
Canton, NY 13617-3302

Phone

(315) 386-4541

NPI assigned

Apr 27, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Jason Matthie

Title

Compliance Officer

Phone

(315) 393-3072

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1651017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651017600000",
    "number": "1356085096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 STATE STREET RD",
            "city": "CANTON",
            "state": "NY",
            "postal_code": "136173302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 STATE STREET RD",
            "city": "CANTON",
            "state": "NY",
            "postal_code": "136173302",
            "telephone_number": "315-386-4541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLEWOOD PHYSICAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-27",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A",
        "authorized_official_last_name": "MATTHIE",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "315-393-3072",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laurie Maki, RN
• Hamza Tarek Malek, M.D.
• Claire Marie Mallette
• Dyan M Mallette, FNP
• Desirae Marie Malone, CRPA-P
• Ruthann M Matthews, CASAC
• Shannon Marie Mayette
• Sebastian Angelo Mazzotta, M.D.
• Thomas P McBride, RPA C
• Mary S McCallion, LCSW

• Physical Therapist in Canton, NY
• Providers in Canton, 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 Apr 27, 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.