Bayside Rehab PT PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

BAYSIDE REHAB PT PC

Practice address

20801 Northern Blvd Ste 3
Bayside, NY 11361-3120

Phone

(347) 777-9707

Fax

(332) 777-1842

NPI assigned

Feb 24, 2020

Last updated

Feb 24, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Marievic Balaag Ebora Fernando, PT, DPTNPI 1629236278

Title

Manager

Phone

(347) 777-9707

Specialties & licenses 1

Addresses

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.

• Marievic Balaag Ebora Fernando, PT, DPT

  • Physical Therapist
  • Forest Hills, NY
  • NPI 1629236278
  Authorized official Same address or phone

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

{
    "created_epoch": "1582502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582502400000",
    "number": "1578197000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20801 NORTHERN BLVD STE 3",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113613120",
            "telephone_number": "347-777-9707",
            "fax_number": "332-777-1842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20801 NORTHERN BLVD STE 3",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113613120",
            "telephone_number": "347-777-9707",
            "fax_number": "332-777-1842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYSIDE REHAB PT PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-24",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A",
        "authorized_official_last_name": "EBORA FERNANDO",
        "authorized_official_first_name": "MARIEVIC",
        "authorized_official_middle_name": "BALAAG",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "347-777-9707",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bayside Pediatric Care P.C.
• Bayside Pediatric Specialists P.C.
• Bayside Pediatrics PC
• Bayside Physical Therapy, Chiropractic & Acupuncture PLLC
• Bayside Professional PT PC
• Bayside RX LLC
• Bayside Speech & Language Pals, PLLC
• Bayside Supply I Inc
• Bayside USA Acupuncture P.C.
• Bayside Vision Corp

• Physical Therapist in Bayside, NY
• Providers in Bayside, 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 24, 2020; 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.