NPIMap

Organization Active NPI

Island Body Works LLC

  • Physical Therapist
  • Grand Island, NY
National Provider Identifier
1548764665
Registry record updated Dec 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
013305-1 Issued in NY
Legal business name
ISLAND BODY WORKS LLC
Practice address
2423 Grand Island Blvd.
Grand Island, NY 14072-2967
Phone
(716) 773-3300
Fax
(716) 773-3303
NPI assigned
Mar 22, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2018

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

Authorized official

Name
Mrs. Lisa Zimmer Trunzo, P.T.NPI 1801858030
Title
Owner
Phone
(716) 773-3300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 013305-1 NY Primary

Addresses

Primary practice location

2423 Grand Island Blvd.
Grand Island, NY 14072-2967

Mailing address

2423 Grand Island Blvd.
Grand Island, NY 14072-2967
Phone (716) 773-3300

Other identifiers 1

IdentifierTypeStateIssuer
04956254MedicaidNY

Other names 1

  • The P.T. Center for Pelvic Disorders Former legal business name

National Provider Directory

National Provider Directory

Locations

2423 Grand Island Blvd
Grand Island, NY 14072
Phone (716) 773-3300

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1521676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543795200000",
    "number": "1548764665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2423 GRAND ISLAND BLVD.",
            "city": "GRAND ISLAND",
            "state": "NY",
            "postal_code": "140722967",
            "telephone_number": "716-773-3300",
            "fax_number": "716-773-3303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2423 GRAND ISLAND BLVD.",
            "city": "GRAND ISLAND",
            "state": "NY",
            "postal_code": "140722967",
            "telephone_number": "716-773-3300",
            "fax_number": "716-773-3303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLAND BODY WORKS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-22",
        "last_updated": "2018-12-03",
        "status": "A",
        "authorized_official_last_name": "TRUNZO",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "ZIMMER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "716-773-3300",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "013305-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04956254",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The P.T. Center for Pelvic Disorders",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Grand Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2018; 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.