Champion Professional Services

Primary specialty

Geriatric Physical TherapistTaxonomy code 2251G0304X

License

18775 Issued in NY

Legal business name

CHAMPION PROFESSIONAL SERVICES

Practice address

93 Tallmadge TRL
Miller Place, NY 11764-2327

Phone

(631) 828-4373

Fax

(631) 828-4373

NPI assigned

Nov 19, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Michael James Lyons, M.S,,P.T.

Title

President

Phone

(631) 828-4373

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1353283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353283200000",
    "number": "1487998183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "93 TALLMADGE TRL",
            "city": "MILLER PLACE",
            "state": "NY",
            "postal_code": "117642327",
            "telephone_number": "631-828-4373",
            "fax_number": "631-828-4373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "93 TALLMADGE TRL",
            "city": "MILLER PLACE",
            "state": "NY",
            "postal_code": "117642327",
            "telephone_number": "631-828-4373",
            "fax_number": "631-828-4373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAMPION PROFESSIONAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-19",
        "last_updated": "2012-11-19",
        "status": "A",
        "authorized_official_last_name": "LYONS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-828-4373",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.S,,P.T."
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Geriatrics",
            "state": "NY",
            "license": "18775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Connie Carro-Purcell
• Renee Castelli
• Jacqueline M Cataldi, RDN
• Alicia Marie Cavanagh, PHARMD
• Kathleen Doreen Cergol, M.A.,L-SLP,CCC,T-SHH
• Childhood Anxiety Solutions, LCSW, PLLC
• Karen Elizabeth Chmiel, MS, RN, ANP-C, CWOCN
• Sara Loren Ciampini, RN
• Sharon Cinquemani, PT
• Joanna Clasen

• Geriatric Physical Therapist in Miller Place, NY
• Providers in Miller Place, NY by specialty
• Geriatric Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2012; 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.