Emory Rehabilitation Service, Inc.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

013592-1 Issued in NY

Legal business name

EMORY REHABILITATION SERVICE, INC.

Practice address

12506 Liberty Ave
South Richmond Hill, NY 11419-2234

Phone

(718) 848-3275

Fax

(718) 848-3929

NPI assigned

Apr 17, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Sunday A Mako, P.T

Title

Director of Rehabilitation

Phone

(718) 848-3275

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1334620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334620800000",
    "number": "1497012314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 WEBER AVE",
            "city": "SAYREVILLE",
            "state": "NJ",
            "postal_code": "088721071",
            "telephone_number": "732-254-8865",
            "fax_number": "732-254-8865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12506 LIBERTY AVE",
            "city": "SOUTH RICHMOND HILL",
            "state": "NY",
            "postal_code": "114192234",
            "telephone_number": "718-848-3275",
            "fax_number": "718-848-3929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMORY REHABILITATION SERVICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-17",
        "last_updated": "2012-04-17",
        "status": "A",
        "authorized_official_last_name": "MAKO",
        "authorized_official_first_name": "SUNDAY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR OF REHABILITATION",
        "authorized_official_telephone_number": "718-848-3275",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "013592-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1528013893",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in South Richmond Hill, NY
• Providers in South Richmond Hill, 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 Apr 17, 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.