Active NPI
Balachandar Janamala
- Physical Therapist
- Brooklyn, NY
National Provider Identifier
1659828176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 040729
- Practice address
- 825 57TH St
Longevous Medical Healthcare, PC
Brooklyn, NY 11220 - Phone
- (646) 750-2090
- NPI assigned
- Sep 1, 2016
- 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 | 040729 | NY | Primary |
Addresses
Primary practice location
825 57TH St
Longevous Medical Healthcare, PC
Brooklyn, NY 11220
Mailing address
8395 Magnolia Ave Apt No
Riverside, CA 92504-3224
Phone (951) 750-9284
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 |
|---|---|---|---|
| 040729 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472688000000",
"number": "1659828176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8395 MAGNOLIA AVE APT NO",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925043224",
"telephone_number": "951-750-9284"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "825 57TH ST",
"address_2": "LONGEVOUS MEDICAL HEALTHCARE, PC",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "11220",
"telephone_number": "646-750-2090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JANAMALA",
"first_name": "BALACHANDAR",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-09-01",
"last_updated": "2016-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "040729",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.