Shishkin Physical Therapy Rehab PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

SHISHKIN PHYSICAL THERAPY REHAB PC

Practice address

107 E Broadway FL 3
New York, NY 10002-7037

Phone

(212) 233-0889

Fax

(212) 233-0898

NPI assigned

Nov 23, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Theda Shishkin, DPTNPI 1861896722

Title

PT

Phone

(347) 320-0155

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.

• Theda Lumagod Shishkin, PT

  • Physical Therapist
  • Bronx, NY
  • NPI 1861896722
  NPD Authorized official

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

{
    "created_epoch": "1606089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606089600000",
    "number": "1649874405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7945 GRAND AVE FL 2",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113734129",
            "telephone_number": "347-320-0155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 E BROADWAY FL 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100027037",
            "telephone_number": "212-233-0889",
            "fax_number": "212-233-0898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHISHKIN PHYSICAL THERAPY REHAB PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-23",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A",
        "authorized_official_last_name": "SHISHKIN",
        "authorized_official_first_name": "THEDA",
        "authorized_official_title_or_position": "PT",
        "authorized_official_telephone_number": "347-320-0155",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04599340",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Prasad R Shirvalkar, MD, PHD
• Julia Ciampa Shirvan, MD, DPHIL
• Simmi Shirwaikar, L.AC
• Caroline Shirzadi, RN, ACNP
• Alfred Shirzadnia, DDS
• Kirill Sergeyevich Shishlov, M.D., MPH
• Shiu Acupuncture PLLC
• Clayton Shiu, L. AC.
• Sonny Ho Shiu
• Wai Kei Shiu

• Physical Therapist in New York, NY
• Providers in New York, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 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.