Active NPI
Christian Alexander Jurak, M.S., P.T.
- Physical Therapist
- Brightwaters, NY
National Provider Identifier
1649316290
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 015172
- Practice address
- 541 Peters Blvd
Brightwaters, NY 11718-1726 - Phone
- (516) 859-4514
- NPI assigned
- Jan 30, 2007
- Last updated
- Aug 10, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | 015172 | NY | Primary |
Addresses
Primary practice location
541 Peters Blvd
Brightwaters, NY 11718-1726
Mailing address
541 Peters Blvd
Brightwaters, NY 11718-1726
Phone (516) 859-4514
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 015172 | NY | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186704000000",
"number": "1649316290",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "541 PETERS BLVD",
"city": "BRIGHTWATERS",
"state": "NY",
"postal_code": "117181726",
"telephone_number": "516-859-4514"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "541 PETERS BLVD",
"city": "BRIGHTWATERS",
"state": "NY",
"postal_code": "117181726",
"telephone_number": "516-859-4514"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JURAK",
"first_name": "CHRISTIAN",
"middle_name": "ALEXANDER",
"name_prefix": "Mr.",
"credential": "M.S., P.T.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-30",
"last_updated": "2007-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "015172",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brightwaters, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 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.