Weston Paxxon PT, OT & SLP, PLLC.

Primary specialty

Geriatric Physical TherapistTaxonomy code 2251G0304X

License

003194-1 Issued in NY

Legal business name

WESTON PAXXON PT, OT & SLP, PLLC.

Practice address

11701 84TH Ave
Suite 915
Kew Gardens, NY 11418-1420

Phone

(718) 441-0479

Fax

(718) 441-0479

NPI assigned

Jun 20, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Roger Raymond Berkley, PT

Title

Executive VP

Phone

(631) 467-3700

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276473600000",
    "number": "1417993338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 PEACHTREE CT",
            "address_2": "SUITE 105",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117414616",
            "telephone_number": "631-467-3700",
            "fax_number": "631-467-0928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11701 84TH AVE",
            "address_2": "SUITE 915",
            "city": "KEW GARDENS",
            "state": "NY",
            "postal_code": "114181420",
            "telephone_number": "718-441-0479",
            "fax_number": "718-441-0479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTON PAXXON PT, OT & SLP, PLLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-20",
        "last_updated": "2010-06-14",
        "status": "A",
        "authorized_official_last_name": "BERKLEY",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "RAYMOND",
        "authorized_official_title_or_position": "EXECUTIVE VP",
        "authorized_official_telephone_number": "631-467-3700",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist, Geriatrics",
            "state": "NY",
            "license": "003194-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Geriatric Physical Therapist in Kew Gardens, NY
• Providers in Kew Gardens, NY by specialty
• Geriatric Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2010; 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.