Dynamic Physical Therapy of Queens PLLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

DYNAMIC PHYSICAL THERAPY OF QUEENS PLLC

Practice address

5718 Woodside Ave
2FLR Suite#103
Woodside, NY 11377-3415

Phone

(718) 205-0030

Fax

(646) 304-8252

NPI assigned

May 29, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Christopher Anthony Bautista, MBA

Title

Practice Admnistrator

Phone

(914) 309-9564

Specialties & licenses 1

Addresses

Other names 1

• Dynamic PT of Queens Doing business as

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

{
    "created_epoch": "1401321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401321600000",
    "number": "1609288331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6248 80TH ST FL 2",
            "city": "MIDDLE VILLAGE",
            "state": "NY",
            "postal_code": "113791323",
            "telephone_number": "718-429-2888",
            "fax_number": "646-304-8252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5718 WOODSIDE AVE",
            "address_2": "2FLR SUITE#103",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113773415",
            "telephone_number": "718-205-0030",
            "fax_number": "646-304-8252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC PHYSICAL THERAPY OF QUEENS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-29",
        "last_updated": "2014-05-29",
        "status": "A",
        "authorized_official_last_name": "BAUTISTA",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "PRACTICE ADMNISTRATOR",
        "authorized_official_telephone_number": "914-309-9564",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dynamic PT of Queens",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dunn-Lea Medical PC
• Gloria Dunnder Leacock, MD
• Lan Ngoc Duong
• Meral Duran, DNP, RN, FNP-BC
• Helen Stephanie Dwork, LMSW
• E Zappi Dermatopathology Lab Inc.
• East Coast Family Health NP PC
• Rossanna Echegoyen, LCSW
• John Benjamin Edwards
• Kristin Ann Eggers, PT, DPT

• Physical Therapy Clinic/Center in Woodside, NY
• Providers in Woodside, NY by specialty
• Physical Therapy Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2014; 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.