Legacy Physiatry Group Pennsylvania, LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

LEGACY PHYSIATRY GROUP PENNSYLVANIA, LLC

Practice address

150 Monument Rd
Ste 207
Bala Cynwyd, PA 19004-1702

Phone

(972) 372-1663

NPI assigned

Apr 23, 2015

Organization subpart

No

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

Authorized official

Name

Vivek Sastry, DO

Title

President/Ceo

Phone

(972) 372-1663

Specialties & licenses 4

Addresses

Other names 1

• Legacy Physiatry Group Doing business as

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

{
    "created_epoch": "1429747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429747200000",
    "number": "1477940740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 CENTRAL PKWY E",
            "address_2": "SUITE 275",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750745561",
            "telephone_number": "972-372-1663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 MONUMENT RD",
            "address_2": "STE 207",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041702",
            "telephone_number": "972-372-1663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY PHYSIATRY GROUP PENNSYLVANIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-23",
        "last_updated": "2015-04-23",
        "status": "A",
        "authorized_official_last_name": "SASTRY",
        "authorized_official_first_name": "VIVEK",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "972-372-1663",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Legacy Physiatry Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lawrence S. Borow MD PC
• Wendy Alison Lax
• Louis Arthur Leaff, MD
• Roy Thomas Lefkoe, MD
• Norma Lefkovitz, PH.D.
• Jenifer Kaufmann Lehrer, M.D.
• Dara Leinweber
• Sherman Nelson Leis, DO
• Jennifer Lengyel
• Leslie G Lenox, L.S.W., DCSW

• Physical Medicine & Rehabilitation Physician in Bala Cynwyd, PA
• Providers in Bala Cynwyd, PA by specialty
• Physical Medicine & Rehabilitation Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2015; 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.