Active NPI
William G Redish, PTA
- Physical Therapy Assistant
- Monticello, NY
National Provider Identifier
1639339823
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 005455-1
- Practice address
- 162 E Broadway
Monticello, NY 12701-8815 - Phone
- (845) 796-1350
- Fax
- (845) 796-1647
- NPI assigned
- Jun 11, 2008
- 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 Therapy Assistant | 225200000X | 005455-1 | NY | Primary |
Addresses
Primary practice location
162 E Broadway
Monticello, NY 12701-8815
Mailing address
162 E Broadway
Monticello, NY 12701-8815
Phone (845) 796-1350
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 |
|---|---|---|---|
| 005455-1 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213142400000",
"number": "1639339823",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "162 E BROADWAY",
"city": "MONTICELLO",
"state": "NY",
"postal_code": "127018815",
"telephone_number": "845-796-1350",
"fax_number": "845-796-1647"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "162 E BROADWAY",
"city": "MONTICELLO",
"state": "NY",
"postal_code": "127018815",
"telephone_number": "845-796-1350",
"fax_number": "845-796-1647"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REDISH",
"first_name": "WILLIAM",
"middle_name": "G",
"name_prefix": "Mr.",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-06-11",
"last_updated": "2008-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NY",
"license": "005455-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Monticello, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.