Renee Koch, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

117678 Issued in NY

Practice address

5700 W Genesee St Ste 2
Camillus, NY 13031-3202

Phone

(315) 468-1050

Fax

(315) 468-1201

NPI assigned

Aug 31, 2022

Last updated

Aug 31, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Renee Piticaru Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Camillus Physical Therapy and Sports Rehabilitation

  dba CNY Physical Therapy and Aquatic Centers

  • Physical Therapist
  • Camillus, NY
  • NPI 1457461006
  NPD

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

{
    "created_epoch": "1661904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1659091544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 W GENESEE ST STE 2",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130313202",
            "telephone_number": "315-468-1050",
            "fax_number": "315-468-1201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 W GENESEE ST STE 2",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130313202",
            "telephone_number": "315-468-1050",
            "fax_number": "315-468-1201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCH",
        "first_name": "RENEE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-31",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "117678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RENEE",
            "last_name": "PITICARU",
            "credential": "PTA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Dainelle Kich, DNP, FNP-BC
• Chong Ki Kim, RPH
• Erin Elizabeth Kintner, FNP-C
• Richard Knezovich, PT
• Alexander Brian Knudsen, M.D.
• Theodore Koh, MD
• Lawrence W Krieger, MD
• Kristin Botwinick LCSW-R
• Ladislava Kulikova, FNP
• Sungeun Kwak

• Physical Therapy Assistant in Camillus, NY
• Providers in Camillus, NY by specialty
• Physical Therapy Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; 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.