Active NPI
Regina Goldman
- Physical Therapist
- Harrison, NY
National Provider Identifier
1356675268
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 25198
- Practice address
- 550 Mamaroneck Ave
Suite 104
Harrison, NY 10528 - Phone
- (914) 777-3737
- Fax
- (914) 777-8705
- NPI assigned
- Sep 24, 2009
- Last updated
- Mar 6, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 031815 | NY | |
| Physical Therapist | 225100000X | 25198 | FL | Primary |
Addresses
Primary practice location
550 Mamaroneck Ave
Suite 104
Harrison, NY 10528
Mailing address
4175 Veterans Memorial Hwy
Suite 202
Ronkonkoma, NY 11779
Phone (631) 580-5200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 031815 | NY | MD | General Practice Dentistry |
| 25198 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1253750400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583452800000",
"number": "1356675268",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4175 VETERANS MEMORIAL HWY",
"address_2": "SUITE 202",
"city": "RONKONKOMA",
"state": "NY",
"postal_code": "11779",
"telephone_number": "631-580-5200",
"fax_number": "631-580-5222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "550 MAMARONECK AVE",
"address_2": "SUITE 104",
"city": "HARRISON",
"state": "NY",
"postal_code": "10528",
"telephone_number": "914-777-3737",
"fax_number": "914-777-8705"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDMAN",
"first_name": "REGINA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-09-24",
"last_updated": "2020-03-06",
"certification_date": "2020-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "031815",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "25198",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Harrison, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.