Genesis Therapeutics Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

017925-1 Issued in NY

Legal business name

GENESIS THERAPEUTICS INC

Practice address

6402 Dewey Ave Apt 13
West New York, NJ 07093-3090

Phone

(917) 724-1018

NPI assigned

Jan 9, 2018

Last updated

Jun 16, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Shakespeare Ngo, PHYSICAL THERAPIST

Title

President

Phone

(917) 724-1018

Specialties & licenses 4

Addresses

Other identifiers 2

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

{
    "created_epoch": "1515456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1437666765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6402 DEWEY AVE APT 13",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "070933090",
            "telephone_number": "917-724-1018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6402 DEWEY AVE APT 13",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "070933090",
            "telephone_number": "917-724-1018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS THERAPEUTICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-09",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "NGO",
        "authorized_official_first_name": "SHAKESPEARE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-724-1018",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHYSICAL THERAPIST"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "017925-1",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "0008162",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "01578F",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "5004",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS EI DOH ID NUMBER",
            "identifier": "395780",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS PT LICENSE NUMBER",
            "identifier": "017925-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janisley Garcia Martinez, DMD
• Robin Garcia, R.PH.
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• Janzel Garzon, DMD
• Gastropath
• Gentle Dental LLP
• Gaius Ghattas
• Raffaele A Gibilisco, MD, PA
• Jaime N Gildengers, MD FACS
• Neil Godhani, PHARM.D

• Physical Therapist in West New York, NJ
• Providers in West New York, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.