Greenland Physical Therapy PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

GREENLAND PHYSICAL THERAPY PC

Doing business as

Greenland Physical Therapy PC

Practice address

387 E Main St Ste 104
Bay Shore, NY 11706-8413

Phone

(516) 270-3673

NPI assigned

Nov 2, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Gleen Bautista Anciro, DPTNPI 1174795314

Title

President

Phone

(917) 495-0831

Specialties & licenses 1

Addresses

Other names 1

• GREENLAND PHYSICAL THERAPY PC Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gleen Bautista Anciro, PT,DPT

  • Physical Therapist
  • Brooklyn, NY
  • NPI 1174795314
  NPD Authorized official

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

{
    "created_epoch": "1604275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620950400000",
    "number": "1528669173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21089",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "110021089",
            "telephone_number": "516-270-3673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "387 E MAIN ST STE 104",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068413",
            "telephone_number": "516-270-3673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENLAND PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-02",
        "last_updated": "2021-05-14",
        "certification_date": "2020-11-07",
        "status": "A",
        "authorized_official_last_name": "ANCIRO",
        "authorized_official_first_name": "GLEEN",
        "authorized_official_middle_name": "BAUTISTA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-495-0831",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GREENLAND PHYSICAL THERAPY PC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "GREENLAND PHYSICAL THERAPY PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jamie Green
• Maria P Green, COTA
• Marie Green, RN
• Paul David Greenblatt, M.D.
• Donna Greenidge
• Gregory Alexander, PH.D. Psychologist, PC
• Jessica Danielle Gregory, CRNA, RN, BSN, MSN
• Mary Elizabeth Gregory
• Sara Michelle Greiche
• Rosetta Grella, MD

• Physical Therapist in Bay Shore, NY
• Providers in Bay Shore, 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 May 14, 2021; 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.