Active NPI
Julius Bryan Gonzaga Delos Reyes, PT
- Physical Therapist
- Kingston, NY
National Provider Identifier
1477021772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 99 Golden Hill Dr
Kingston, NY 12401-6442 - Phone
- (845) 340-3390
- NPI assigned
- Nov 5, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
99 Golden Hill Dr
Kingston, NY 12401-6442
Mailing address
3921 N Marshall St
Philadelphia, PA 19140-3217
Phone (267) 504-6901
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1541376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1541376000000",
"number": "1477021772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3921 N MARSHALL ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191403217",
"telephone_number": "267-504-6901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "99 GOLDEN HILL DR",
"city": "KINGSTON",
"state": "NY",
"postal_code": "124016442",
"telephone_number": "845-340-3390"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELOS REYES",
"first_name": "JULIUS BRYAN",
"middle_name": "GONZAGA",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-11-05",
"last_updated": "2018-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Kingston, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.