Othniel Physical Therapy PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

OTHNIEL PHYSICAL THERAPY PC

Practice address

444 Middleneck Rd
Suite 1H
Greatneck, NY 11023

Phone

(917) 334-5552

Fax

(516) 570-6282

NPI assigned

Nov 30, 2018

Last updated

Nov 30, 2018By the provider in NPPES

Organization subpart

Yes

Parent organization

OTHNIEL PHYSICAL THERAPY PCAs reported in NPPES

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

Authorized official

Name

Elian Ramezani, DPT

Title

President, Ceo

Phone

(917) 334-5552

Specialties & licenses 1

Addresses

Part of

Othniel Physical Therapy PC

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.

• Eliian Ramezani

  • Physical Therapist
  • Great Neck, NY
  • NPI 1356772156
  NPD (past)

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

{
    "created_epoch": "1543536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543536000000",
    "number": "1609346774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 MIDDLENECK RD",
            "address_2": "SUITE 1H",
            "city": "GREATNECK",
            "state": "NY",
            "postal_code": "11023",
            "telephone_number": "917-334-5552",
            "fax_number": "516-570-6282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 MIDDLENECK RD",
            "address_2": "SUITE 1H",
            "city": "GREATNECK",
            "state": "NY",
            "postal_code": "11023",
            "telephone_number": "917-334-5552",
            "fax_number": "516-570-6282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OTHNIEL PHYSICAL THERAPY PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OTHNIEL PHYSICAL THERAPY PC",
        "enumeration_date": "2018-11-30",
        "last_updated": "2018-11-30",
        "status": "A",
        "authorized_official_last_name": "RAMEZANI",
        "authorized_official_first_name": "ELIAN",
        "authorized_official_title_or_position": "PRESIDENT, CEO",
        "authorized_official_telephone_number": "917-334-5552",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Great Neck, NY
• Providers in Great Neck, 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 30, 2018; 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.