Peter Adekola Fasanya, PT,DPT

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

027197 Issued in NY

Practice address

91 Elzey Ave
Elmont, NY 11003-1532

Phone

(718) 736-4632

Fax

(516) 352-4548

NPI assigned

Oct 7, 2008

Last updated

Oct 7, 2008By the provider in NPPES

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Elim Healthcare Services, P.T.P.C.

  • Physical Therapy Clinic/Center
  • Hollis, NY
  • NPI 1730194549
  NPD (past)

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

{
    "created_epoch": "1223337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223337600000",
    "number": "1437300605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 ELZEY AVE",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110031532",
            "telephone_number": "718-736-4632",
            "fax_number": "516-352-4548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 ELZEY AVE",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110031532",
            "telephone_number": "718-736-4632",
            "fax_number": "516-352-4548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASANYA",
        "first_name": "PETER",
        "middle_name": "ADEKOLA",
        "name_prefix": "Mr.",
        "credential": "PT,DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-07",
        "last_updated": "2008-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "NY",
            "license": "027197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Motunrayo J Fadugba, PHARMD
• Oluwatoyin John Fadugba, PT
• Fagan Residence
• Family & Children's Association West Nassau Comm
• Family Health Nurse Practitioner of Elmont Professional Corporation
• Olufemi Fatukasi, LPN
• Favorite Nursing
• Stuart Feinstein, M.D.
• Roger P Feldman, M.D.
• Marie Flore Felix

• Community Health Worker in Elmont, NY
• Providers in Elmont, NY by specialty
• Community Health Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2008; 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.