Active NPI
Ellen Wang
- Physical Therapist
- Elmhurst, NY
National Provider Identifier
1386950509
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 032895
- Practice address
- 7901 Broadway
Elmhurst, NY 11373-1329 - Phone
- (187) 334-2611
- Fax
- (718) 334-5006
- NPI assigned
- Aug 25, 2010
- 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 | 032895 | NY | Primary |
Addresses
Primary practice location
7901 Broadway
Elmhurst, NY 11373-1329
Mailing address
7901 Broadway
Elmhurst, NY 11373-1329
Phone (187) 334-2611
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00318823 | Medicaid | NY |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1282694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599782400000",
"number": "1386950509",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7901 BROADWAY",
"city": "ELMHURST",
"state": "NY",
"postal_code": "113731329",
"telephone_number": "187-334-2611",
"fax_number": "718-334-5006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7901 BROADWAY",
"city": "ELMHURST",
"state": "NY",
"postal_code": "113731329",
"telephone_number": "187-334-2611",
"fax_number": "718-334-5006"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WANG",
"first_name": "ELLEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-08-25",
"last_updated": "2020-09-11",
"certification_date": "2020-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "032895",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00318823",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elmhurst, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.