Active NPI
Kimberly Elizabeth Gliganic, M.S., P.T.
- Physical Therapist
- Stony Brook, NY
National Provider Identifier
1548332869
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 024961-1
- Practice address
- 10 Pensdale CT
Stony Brook, NY 11790-2638 - Phone
- (631) 246-9041
- NPI assigned
- Nov 14, 2006
- Sex
- Female
- 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 | 024961-1 | NY | Primary |
Addresses
Primary practice location
10 Pensdale CT
Stony Brook, NY 11790-2638
Mailing address
10 Pensdale Court
Stony Brook, TX 11790
Phone (631) 246-9041
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 024961-1 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1548332869",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 PENSDALE COURT",
"city": "STONY BROOK",
"state": "TX",
"postal_code": "11790",
"telephone_number": "631-246-9041"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 PENSDALE CT",
"city": "STONY BROOK",
"state": "NY",
"postal_code": "117902638",
"telephone_number": "631-246-9041"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLIGANIC",
"first_name": "KIMBERLY",
"middle_name": "ELIZABETH",
"credential": "M.S., P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "024961-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stony Brook, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.