Praveen George Issac, P.T

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

034988 Issued in NY

Practice address

670 Stoneleigh Ave
Carmel, NY 10512-3997

Phone

(845) 279-5711

Fax

(845) 279-2059

NPI assigned

Nov 7, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1352246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352246400000",
    "number": "1578817912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 STONELEIGH AVE",
            "city": "CARMEL",
            "state": "NY",
            "postal_code": "105123997",
            "telephone_number": "845-279-5711",
            "fax_number": "845-279-2059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 STONELEIGH AVE",
            "city": "CARMEL",
            "state": "NY",
            "postal_code": "105123997",
            "telephone_number": "845-279-5711",
            "fax_number": "845-279-2059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISSAC",
        "first_name": "PRAVEEN",
        "middle_name": "GEORGE",
        "name_prefix": "Mr.",
        "credential": "P.T",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-11-07",
        "last_updated": "2012-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "034988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Inspiration Physical Therapy PLLC
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• Marlom Irvis
• Fateema Islam, D.O
• Hillary Jackson, CASAC-T
• Frankie C Janiec, LMSW
• Jay a. Motola, MD
• Mallory Jennes
• Jo Jo Bees

• Physical Therapist in Carmel, NY
• Providers in Carmel, 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 Nov 7, 2012; 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.