Four Square Physical Therapy PC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

FOUR SQUARE PHYSICAL THERAPY PC

Practice address

8411 Queens Blvd
Elmhurst, NY 11373-3098

Phone

(929) 522-0841

Fax

(929) 522-0843

NPI assigned

Jan 17, 2020

Organization subpart

No

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

Authorized official

Name

Al Manjoorsa, PTNPI 1851510630

Title

President

Phone

(347) 968-8304

Specialties & licenses 2

Addresses

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.

• Al Manjoorsa, PT

  • Physical Therapist
  • Elmhurst, NY
  • NPI 1851510630
  Authorized official Same address or phone

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

{
    "created_epoch": "1579219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579219200000",
    "number": "1629608732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8411 QUEENS BLVD",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113733098",
            "telephone_number": "929-522-0841",
            "fax_number": "929-522-0843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8411 QUEENS BLVD",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113733098",
            "telephone_number": "929-522-0841",
            "fax_number": "929-522-0843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUR SQUARE PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-17",
        "last_updated": "2020-01-17",
        "certification_date": "2020-01-17",
        "status": "A",
        "authorized_official_last_name": "MANJOORSA",
        "authorized_official_first_name": "AL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "347-968-8304",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nili Hannah Forgy
• Lisa Dianne Forman, M.D.
• Adolfo Fortier, LMSW
• Yanique Simone Foster
• Four B's Pharmacy Inc
• Armando F Fox, MD
• Barbara Waclawa Frackowiak, M.D.
• Dino Baylon Francisco
• Lauren Brittany Gongora Francisco, MD
• Diana Franco, LCSW-R, DSW

• Physical Therapy Clinic/Center in Elmhurst, NY
• Providers in Elmhurst, NY by specialty
• Physical Therapy Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2020; 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.