Premiere Physical Therapy, PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

028150 Issued in NY

Legal business name

PREMIERE PHYSICAL THERAPY, PC

Practice address

56 Onderdonk Rd
Warick, NY 10990

Phone

(718) 758-4520

NPI assigned

Jan 14, 2009

Last updated

Jan 14, 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

Raouf Akl

Title

DPT/Owner

Phone

(718) 758-4520

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1231891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231891200000",
    "number": "1366689200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 BAY 29TH STREET",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112140000",
            "telephone_number": "718-758-4520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 ONDERDONK RD",
            "city": "WARICK",
            "state": "NY",
            "postal_code": "10990",
            "telephone_number": "718-758-4520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIERE PHYSICAL THERAPY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-14",
        "last_updated": "2009-01-14",
        "status": "A",
        "authorized_official_last_name": "AKL",
        "authorized_official_first_name": "RAOUF",
        "authorized_official_title_or_position": "DPT/OWNER",
        "authorized_official_telephone_number": "718-758-4520"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "028150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.