Individual provider Active NPI

Sheila Marie Pahang, PTA

  • Physical Therapy Assistant
  • Bronx, NY
National Provider Identifier
1356860563
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
008777-1 Issued in NY
Practice address
1221 Jerome Ave
Bronx, NY 10452-3301
Phone
(718) 538-8343
Fax
(718) 228-3771
NPI assigned
Sep 19, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 008777-1 NY Primary

Addresses

Primary practice location

1221 Jerome Ave
Bronx, NY 10452-3301

Mailing address

1221 Jerome Ave
Bronx, NY 10452
Phone (718) 538-8343

Other practice location 1

1221 Jerome Ave
Bronx, NY 10452-3301
Phone (718) 538-8343

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
008777-1NYMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1505779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1356860563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 JEROME AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10452",
            "telephone_number": "718-538-8343",
            "fax_number": "718-228-3771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 JEROME AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104523301",
            "telephone_number": "718-538-8343",
            "fax_number": "718-228-3771"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1221 Jerome Ave",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104523301",
            "country_code": "US",
            "telephone_number": "718-538-8343",
            "fax_number": "718-228-3771",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAHANG",
        "first_name": "SHEILA",
        "middle_name": "MARIE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-19",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "008777-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.