Organization Active NPI

Back in Balance Physical Therapy and Sport Rehabilitation, PLLC

  • Physical Therapist
  • Middletown, NY
National Provider Identifier
1396825063
Registry record updated Nov 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
BACK IN BALANCE PHYSICAL THERAPY AND SPORT REHABILITATION, PLLC
Practice address
726 E Main St
Suite 102
Middletown, NY 10940-2653
Phone
(845) 692-2225
Fax
(845) 692-2239
NPI assigned
Oct 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2012

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

Authorized official

Name
Tomasz Pienkowski, PT
Title
Partner
Phone
(845) 692-2225

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

726 E Main St
Suite 102
Middletown, NY 10940-2653

Mailing address

726 E Main St
Suite 102
Middletown, NY 10940-2653
Phone (845) 692-2225

National Provider Directory

National Provider Directory

Locations

726 E Main St
Ste 102
Middletown, NY 10940
Phone (845) 394-0080

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352419200000",
    "number": "1396825063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "726 E MAIN ST",
            "address_2": "SUITE 102",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109402653",
            "telephone_number": "845-692-2225",
            "fax_number": "845-692-2239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "726 E MAIN ST",
            "address_2": "SUITE 102",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109402653",
            "telephone_number": "845-692-2225",
            "fax_number": "845-692-2239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK IN BALANCE PHYSICAL THERAPY AND SPORT REHABILITATION, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2012-11-09",
        "status": "A",
        "authorized_official_last_name": "PIENKOWSKI",
        "authorized_official_first_name": "TOMASZ",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "845-692-2225",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2012; 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.