Wynn Physical Therapy PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

WYNN PHYSICAL THERAPY PC

Practice address

464 Manor Rd
Staten Island, NY 10314-2956

Phone

(718) 442-6690

Fax

(718) 390-6900

NPI assigned

Mar 6, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Wynn Abraham Rajan, M.D.

Title

Owner

Phone

(718) 442-6690

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1236297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236297600000",
    "number": "1467692285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "464 MANOR RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103142956",
            "telephone_number": "718-442-6690",
            "fax_number": "718-390-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "464 MANOR RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103142956",
            "telephone_number": "718-442-6690",
            "fax_number": "718-390-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYNN PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-06",
        "last_updated": "2009-03-06",
        "status": "A",
        "authorized_official_last_name": "RAJAN",
        "authorized_official_first_name": "WYNN",
        "authorized_official_middle_name": "ABRAHAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-442-6690",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shuyung J Wu, M.D.
• Vivian Wu, NP
• William Wu, DO
• Wyckoff Family Medical Services
• Jamshad Iqbal Wyne, MD
• Alexandria Rose Xepolitos, FNP
• Albana Xhafa
• Violet Xhuglini
• Sydney Morgan Xhunga, PA-C
• Mandy XI, PA-C

• Physical Therapist in Staten Island, NY
• Providers in Staten Island, 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 Mar 6, 2009; 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.