Individual provider Active NPI

Chung-Yuh Soong, P.T.

  • Physical Therapist
  • Canandaigua, NY
National Provider Identifier
1629135488
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
025024-1 Issued in NY
Practice address
5415 N Bloomfield Rd
Canandaigua, NY 14424-7964
Phone
(585) 394-9510
Fax
(585) 394-5326
NPI assigned
Jan 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 025024-1 NY Primary

Addresses

Primary practice location

5415 N Bloomfield Rd
Canandaigua, NY 14424-7964

Mailing address

47 Cape Cod Way
Rochester, NY 14623-5401
Phone (585) 334-5643

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
025024-1NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629135488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 CAPE COD WAY",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146235401",
            "telephone_number": "585-334-5643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5415 N BLOOMFIELD RD",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144247964",
            "telephone_number": "585-394-9510",
            "fax_number": "585-394-5326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOONG",
        "first_name": "CHUNG-YUH",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "025024-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canandaigua, 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.

Verify at the official NPI Registry.