Active NPI
John Paul Gozaloff, PT
- Physical Therapist
- Roslyn, NY
National Provider Identifier
1619052644
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 015417
- Practice address
- 100 Port Washington Blvd
Roslyn, NY 11576 - Phone
- (516) 562-6000
- NPI assigned
- Oct 26, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 015417 | NY | Primary |
Addresses
Primary practice location
100 Port Washington Blvd
Roslyn, NY 11576
Mailing address
3904 Beacon Rd
Seaford, NY 11783
Phone (516) 826-1051
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 015417 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1619052644",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3904 BEACON RD",
"city": "SEAFORD",
"state": "NY",
"postal_code": "11783",
"telephone_number": "516-826-1051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 PORT WASHINGTON BLVD",
"city": "ROSLYN",
"state": "NY",
"postal_code": "11576",
"telephone_number": "516-562-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOZALOFF",
"first_name": "JOHN",
"middle_name": "PAUL",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "015417",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roslyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.