Pro-Health Medical P.C.

Primary specialty

Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X

License

241419 Issued in NY

Legal business name

PRO-HEALTH MEDICAL P.C.

Practice address

4265 Kissena Blvd #517
Flushing, NY 11355

Phone

(718) 577-8863

Fax

(718) 358-2806

NPI assigned

Feb 13, 2009

Last updated

Feb 13, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Jenny Jia, MD

Title

Clinic Manager

Phone

(718) 577-8863

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1234483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234483200000",
    "number": "1366681330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4265 KISSENA BLVD #517",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11355",
            "telephone_number": "718-577-8863",
            "fax_number": "718-358-2806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4265 KISSENA BLVD #517",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11355",
            "telephone_number": "718-577-8863",
            "fax_number": "718-358-2806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO-HEALTH MEDICAL P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-13",
        "last_updated": "2009-02-13",
        "status": "A",
        "authorized_official_last_name": "JIA",
        "authorized_official_first_name": "JENNY",
        "authorized_official_title_or_position": "CLINIC MANAGER",
        "authorized_official_telephone_number": "718-577-8863",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "003201",
            "primary": false
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "NY",
            "license": "241419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Promedex. Inc (Procare)

• Physical Rehabilitation Occupational Therapist in Flushing, NY
• Providers in Flushing, NY by specialty
• Physical Rehabilitation Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2009; 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.