Organization Active NPI

Action Medical and Rehab PC

  • Physical Medicine & Rehabilitation Physician
  • East Setauket, NY
National Provider Identifier
1366935397
Registry record updated Jun 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
ACTION MEDICAL AND REHAB PC
Practice address
3400 Nesconset Hwy Ste 104
East Setauket, NY 11733-3327
Phone
(316) 898-6626
NPI assigned
Jun 13, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2018

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

Authorized official

Name
Dr. Edward Tanza
Title
Ceo
Phone
(904) 654-2410

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

3400 Nesconset Hwy Ste 104
East Setauket, NY 11733-3327

Mailing address

665 Treehouse Cir
Saint Augustine, FL 32095-6837
Phone (904) 654-2410

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1528848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528848000000",
    "number": "1366935397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "665 TREEHOUSE CIR",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320956837",
            "telephone_number": "904-654-2410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 NESCONSET HWY STE 104",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117333327",
            "telephone_number": "316-898-6626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTION MEDICAL AND REHAB PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-13",
        "last_updated": "2018-06-13",
        "status": "A",
        "authorized_official_last_name": "TANZA",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-654-2410",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Setauket, NY

Sources for this page

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