NPIMap

Organization Active NPI

Professional Orthopedic and Sports Physical Therapy PC

  • Physical Therapist
  • New York, NY
National Provider Identifier
1366852584
Registry record updated Mar 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY PC
Practice address
521 5TH Ave
New York, NY 10175-0003
Phone
(212) 692-9558
Fax
(212) 692-9262
NPI assigned
Apr 28, 2014
Last updated
Mar 30, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2018

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

Authorized official

Name
Leticia Pabellon
Title
VP of Administrative Operations
Phone
(516) 321-2447

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

521 5TH Ave
New York, NY 10175-0003

Mailing address

576 Broadhollow Rd
Melville, NY 11747-5002
Phone (212) 692-9558

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1398643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522368000000",
    "number": "1366852584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 BROADHOLLOW RD",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117475002",
            "telephone_number": "212-692-9558",
            "fax_number": "212-692-9262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 5TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101750003",
            "telephone_number": "212-692-9558",
            "fax_number": "212-692-9262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-28",
        "last_updated": "2018-03-30",
        "status": "A",
        "authorized_official_last_name": "PABELLON",
        "authorized_official_first_name": "LETICIA",
        "authorized_official_title_or_position": "VP OF ADMINISTRATIVE OPERATIONS",
        "authorized_official_telephone_number": "516-321-2447"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "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 Mar 30, 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.