Fruition Physical Therapy PLLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

FRUITION PHYSICAL THERAPY PLLC

Practice address

2747 Crescent St Ste 203
Astoria, NY 11102-3142

Phone

(347) 869-9798

NPI assigned

May 19, 2021

Organization subpart

No

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

Authorized official

Name

Ode EgharevbaNPI 1578159422

Title

Owner

Phone

(347) 869-9798

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ode Egharevba, PT, DPT

  • Physical Therapist
  • Astoria, NY
  • NPI 1578159422
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1621382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637020800000",
    "number": "1386218733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BROADWAY UNIT 594",
            "city": "LYNBROOK",
            "state": "NY",
            "postal_code": "115635013",
            "telephone_number": "347-869-9798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2747 CRESCENT ST STE 203",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111023142",
            "telephone_number": "347-869-9798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRUITION PHYSICAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-19",
        "last_updated": "2021-11-16",
        "certification_date": "2021-11-16",
        "status": "A",
        "authorized_official_last_name": "EGHAREVBA",
        "authorized_official_first_name": "ODE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "347-869-9798"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick Frey
• Michael Fricchione, D.D.S.
• Remy Friedman, MD
• Jeanne Windle Friedrichs, OTR/L
• Costas Frousios, M.D.
• Fucancer
• Oscar Jorge Fukilman, M.D.
• Full Scope Mental Health Counseling PLLC
• Allison Fuller
• Function Enhancing Physical Therapy PLLC

• Physical Therapist in Astoria, NY
• Providers in Astoria, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.