Brian Scott Fogu, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

029581 Issued in NY

Practice address

159 W 1St St
Oswego, NY 13126-2045

Phone

(315) 342-9575

Fax

(315) 342-7664

NPI assigned

Aug 8, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1186531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554249600000",
    "number": "1407047012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 W 1ST ST",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131262045",
            "telephone_number": "315-342-9575",
            "fax_number": "315-342-7664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 W 1ST ST",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131262045",
            "telephone_number": "315-342-9575",
            "fax_number": "315-342-7664"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4994 W Seneca Tpke",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132152279",
            "country_code": "US",
            "telephone_number": "315-469-5990",
            "fax_number": "315-469-5650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOGU",
        "first_name": "BRIAN",
        "middle_name": "SCOTT",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-08",
        "last_updated": "2019-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "029581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Oswego, NY
• Providers in Oswego, 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 Apr 3, 2019; 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.