Active NPI
Ryu Andre Marcus Primero, PT
- Physical Therapist
- New York, NY
National Provider Identifier
1366233124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 050685
- Practice address
- 332 E 34TH St, 1E
New York, NY 10016 - Phone
- (212) 651-4380
- NPI assigned
- May 13, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 050685 | NY | Primary |
Addresses
Primary practice location
332 E 34TH St, 1E
New York, NY 10016
Mailing address
72-38 113TH Street, Apt 4B Forest Hills
New York City, NY 11375
Phone (414) 249-1601
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
| License | State | Type | Specialty |
|---|---|---|---|
| 050685 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1747094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750291200000",
"number": "1366233124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "72-38 113TH STREET, APT 4B FOREST HILLS",
"city": "NEW YORK CITY",
"state": "NY",
"postal_code": "11375",
"telephone_number": "414-249-1601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "332 E 34TH ST, 1E",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10016",
"telephone_number": "212-651-4380"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRIMERO",
"first_name": "RYU ANDRE MARCUS",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-05-13",
"last_updated": "2025-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "NY",
"license": "050685",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.