Amy Srebnik, P.T.

Primary specialty

SpecialistTaxonomy code 174400000X

License

40QA01672900 Issued in NJ

Practice address

150 New Providence Rd
Mountainside, NJ 07092-2590

Phone

(908) 233-3720

NPI assigned

Oct 13, 2016

Last updated

Oct 13, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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": "1476316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476316800000",
    "number": "1609326610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 CAROL RD",
            "city": "WESTFIELD",
            "state": "NJ",
            "postal_code": "070901819",
            "telephone_number": "201-707-2692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 NEW PROVIDENCE RD",
            "city": "MOUNTAINSIDE",
            "state": "NJ",
            "postal_code": "070922590",
            "telephone_number": "908-233-3720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SREBNIK",
        "first_name": "AMY",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-13",
        "last_updated": "2016-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "40QA01672900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Mountainside, NJ
• Providers in Mountainside, NJ by specialty
• Specialist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2016; 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.