Bounce Physical Therapy PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

020377 Issued in NY

Legal business name

BOUNCE PHYSICAL THERAPY PC

Practice address

4205 Long Branch Rd
Liverpool, NY 13090-3213

Phone

(315) 295-2100

Fax

(315) 295-2125

NPI assigned

Jan 4, 2007

Organization subpart

No

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

Authorized official

Name

Crystal A Duda, PTNPI 1144320201

Title

Physical Therapist

Phone

(315) 295-2100

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Crystal Anne Duda, PT

  • Physical Therapist
  • Liverpool, NY
  • NPI 1144320201
  Medicare reassignment NPD Authorized official
• Nicole M Reynolds, PT

  • Physical Therapist
  • Liverpool, NY
  • NPI 1235384769
  NPD (past)

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191369600000",
    "number": "1669529681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4567 CROSSROADS PARK DR",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130883589",
            "telephone_number": "315-295-2100",
            "fax_number": "315-295-2125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4205 LONG BRANCH RD",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130903213",
            "telephone_number": "315-295-2100",
            "fax_number": "315-295-2125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOUNCE PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2007-10-03",
        "status": "A",
        "authorized_official_last_name": "DUDA",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "315-295-2100",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "020377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bonnie J Wolniak
• Rebecca Conklin Bono, RN
• Geralda Borgard, LMSW
• Frederick Bosco
• Renee Boulware, MD
• Mackenzie Bourdon
• Marquita Bowen
• Cody Ashton Ryan Bowser
• Cassandra Lynn Boyce, LMT
• Karen Boyle

• Physical Therapist in Liverpool, NY
• Providers in Liverpool, 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 Oct 3, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.