Gary S Willner, DC, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

004780-1 Issued in NY

Practice address

370 Lexington Ave
RM 1212
New York, NY 10017-6584

Phone

(212) 953-6040

Fax

(212) 953-0089

NPI assigned

Oct 31, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Outreach Physical and Occupational Therapy & Speech Rehabilitation, PLLC

  • Physical Therapist
  • Great Neck, NY
  • NPI 1841526399
  Medicare reassignment NPD
• Integrative Physical Therapy of Nyc P.C.

  • Physical Therapist
  • New York, NY
  • NPI 1235554866
  Medicare reassignment

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487721600000",
    "number": "1568548659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 LEXINGTON AVE",
            "address_2": "RM 1212",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100176584",
            "telephone_number": "212-953-6040",
            "fax_number": "212-953-0089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 LEXINGTON AVE",
            "address_2": "RM 1212",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100176584",
            "telephone_number": "212-953-6040",
            "fax_number": "212-953-0089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLNER",
        "first_name": "GARY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DC, PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2017-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X003779-1",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "004780-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rodney Willis Jr.
• Trellane Arthur Willis, MD
• Wesley Demarius Willis, PSY.D, LCSW-R, RN
• Damon Willlngham Jr., MHC-LP
• Carly Willmes
• Judith Pleasure Willner, M.D.
• Orin L. Willner, L.C.S.W.
• Susan Fial Willner, P.T.
• Colin Jack Willoughby
• Kristin Willoughby

• Physical Therapist in New York, NY
• Providers in New York, 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 Feb 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.