Individual provider Active NPI

Maria Donna C Fetalco, PHYSICAL THERAPIST

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1396840799
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
023992-1 Issued in NY
Practice address
263 7TH Avenue
Suite 2a
Brooklyn, NY 11215-3689
Phone
(718) 369-8000
Fax
(718) 369-8038
NPI assigned
Sep 13, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 023992-1 NY Primary

Addresses

Primary practice location

263 7TH Avenue
Suite 2a
Brooklyn, NY 11215-3689

Mailing address

263 7TH Avenue
Suite 2a
Brooklyn, NY 11215-3689
Phone (718) 369-8000

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

LicenseStateTypeSpecialty
023992-1NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396840799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 7TH AVENUE",
            "address_2": "SUITE 2A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112153689",
            "telephone_number": "718-369-8000",
            "fax_number": "718-369-8038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 7TH AVENUE",
            "address_2": "SUITE 2A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112153689",
            "telephone_number": "718-369-8000",
            "fax_number": "718-369-8038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "C FETALCO",
        "first_name": "MARIA",
        "middle_name": "DONNA",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "023992-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.