Individual provider Active NPI

Phalak Pankaj Buch

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1407746688
Registry record updated Sep 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
054216 Issued in NY
Practice address
1118 Bedford Ave
Brooklyn, NY 11216-5578
Phone
(718) 587-5791
Fax
(718) 587-5792
NPI assigned
Jul 8, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2025

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 054216 NY Primary

Addresses

Primary practice location

1118 Bedford Ave
Brooklyn, NY 11216-5578

Mailing address

59 Beacon Ave Apt 1
Jersey City, NJ 07306-1513
Phone (201) 850-0308

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
054216NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1751932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758585600000",
    "number": "1407746688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 BEACON AVE APT 1",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073061513",
            "telephone_number": "201-850-0308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1118 BEDFORD AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112165578",
            "telephone_number": "718-587-5791",
            "fax_number": "718-587-5792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCH",
        "first_name": "PHALAK",
        "middle_name": "PANKAJ",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-07-08",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "054216",
            "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 Sep 23, 2025; 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.