Active NPI
Elizabeth Anne Roque, P.T.
- Physical Therapist
- Bronx, NY
National Provider Identifier
1386893261
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 030183-1
- Practice address
- 3265 Johnson Ave
Bronx, NY 10463-3539 - Phone
- (718) 432-1323
- Fax
- (718) 432-1326
- NPI assigned
- Sep 16, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 030183-1 | NY | Primary |
Addresses
Primary practice location
3265 Johnson Ave
Bronx, NY 10463-3539
Mailing address
3265 Johnson Ave
Bronx, NY 10463-3539
Phone (718) 432-1323
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 030183-1 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433289600000",
"number": "1386893261",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3265 JOHNSON AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104633539",
"telephone_number": "718-432-1323",
"fax_number": "718-432-1326"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3265 JOHNSON AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104633539",
"telephone_number": "718-432-1323",
"fax_number": "718-432-1326"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROQUE",
"first_name": "ELIZABETH",
"middle_name": "ANNE",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-16",
"last_updated": "2015-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "030183-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.