Source of Physical Therapy PC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

025885 Issued in NY

Legal business name

SOURCE OF PHYSICAL THERAPY PC

Practice address

4051 Junction Blvd FL 2
Corona, NY 11368-2121

Phone

(718) 880-8468

NPI assigned

Jul 2, 2013

Last updated

Jul 2, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Margarita Muguruza, PTNPI 1427140714

Title

Owner

Phone

(718) 880-8468

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Margarita Muguruza, PHYSICAL THERAPIST

  • Physical Therapist
  • Flushing, NY
  • NPI 1427140714
  NPD (past) Authorized official

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

{
    "created_epoch": "1372723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372723200000",
    "number": "1619317815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4051 JUNCTION BLVD FL 2",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113682121",
            "telephone_number": "718-880-8468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4051 JUNCTION BLVD FL 2",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113682121",
            "telephone_number": "718-880-8468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOURCE OF PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-02",
        "last_updated": "2013-07-02",
        "status": "A",
        "authorized_official_last_name": "MUGURUZA",
        "authorized_official_first_name": "MARGARITA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-880-8468",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "025885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03434104",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mojgan Soleimani-Khalili
• Sols 4 Pharmacy Inc (Sol's Pharmacy)
• Sop Medical PC
• Aliana Sosa, LMHC
• Jean Vernet Souffrant Sr., MA NCPSYA
• St. Raphael Pharmacy Inc (St Raphael Chemists)
• Sofia Starayeva
• Amelia Stoklosa
• Sun Mountain Medical PLLC
• Frederick Sun, PT, DPT

• Physical Medicine & Rehabilitation Physician in Corona, NY
• Providers in Corona, NY by specialty
• Physical Medicine & Rehabilitation Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2013; 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.