Active NPI
Demler Bedayo, PT
- Physical Therapist
- Clifton, NJ
National Provider Identifier
1487089009
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 40QA00825700
- Practice address
- 1070 Clifton Ave
Clifton, NJ 07013-3619 - Phone
- (973) 246-6565
- Fax
- (973) 883-0140
- NPI assigned
- Sep 13, 2013
- Sex
- Male
- Sole proprietor
- No
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 | 40QA00825700 | NJ | Primary |
Addresses
Primary practice location
1070 Clifton Ave
Clifton, NJ 07013-3619
Mailing address
1070 Clifton Ave
Clifton, NJ 07013-3619
Phone (973) 246-6565
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40QA00825700 | NJ | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1379030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379030400000",
"number": "1487089009",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1070 CLIFTON AVE",
"city": "CLIFTON",
"state": "NJ",
"postal_code": "070133619",
"telephone_number": "973-246-6565",
"fax_number": "973-883-0140"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1070 CLIFTON AVE",
"city": "CLIFTON",
"state": "NJ",
"postal_code": "070133619",
"telephone_number": "973-246-6565",
"fax_number": "973-883-0140"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEDAYO",
"first_name": "DEMLER",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-09-13",
"last_updated": "2013-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QA00825700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clifton, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.