Sunrise Kinetic Physical Therapy PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

022367 Issued in NY

Legal business name

SUNRISE KINETIC PHYSICAL THERAPY PC

Practice address

210 E Sunrise Hwy Ste 101
Valley Stream, NY 11581-1330

Phone

(347) 216-5229

NPI assigned

Jan 27, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Anthony Camacho, PT

Title

President

Phone

(347) 216-5229

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1485475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485475200000",
    "number": "1396282380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 E SUNRISE HWY STE 101",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115811330",
            "telephone_number": "347-216-5229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 E SUNRISE HWY STE 101",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115811330",
            "telephone_number": "347-216-5229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNRISE KINETIC PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-27",
        "last_updated": "2017-01-27",
        "status": "A",
        "authorized_official_last_name": "CAMACHO",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "347-216-5229",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "022367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Valley Stream, NY
• Providers in Valley Stream, 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 Jan 27, 2017; 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.