Pro Sports Performance Physical Therapy PC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

029855 Issued in NY

Legal business name

PRO SPORTS PERFORMANCE PHYSICAL THERAPY PC

Practice address

190 Broadway
Garden City Park, NY 11040-5333

Phone

(516) 510-3713

Fax

(516) 246-2869

NPI assigned

Nov 20, 2009

Organization subpart

No

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

Authorized official

Name

William George Peters, PTNPI 1831374545

Title

President/Owner

Phone

(516) 510-3713

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 3

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

• William Peters, PT

  • Physical Therapist
  • New Hyde Park, NY
  • NPI 1831374545
  Medicare reassignment Care Compare group NPD Authorized official
• Courtney Marie Prezioso, MPT

  • Physical Therapist
  • Manhasset, NY
  • NPI 1386984516
  Medicare reassignment Care Compare group NPD
• Andrew Rosenberg, PTDPT

  • Physical Therapist
  • New York, NY
  • NPI 1508168295
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1258675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258675200000",
    "number": "1669700126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 FERNWOOD TER",
            "city": "STEWART MANOR",
            "state": "NY",
            "postal_code": "115305011",
            "telephone_number": "516-510-3713",
            "fax_number": "516-248-2869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 BROADWAY",
            "city": "GARDEN CITY PARK",
            "state": "NY",
            "postal_code": "110405333",
            "telephone_number": "516-510-3713",
            "fax_number": "516-246-2869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO SPORTS PERFORMANCE PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-20",
        "last_updated": "2009-11-20",
        "status": "A",
        "authorized_official_last_name": "PETERS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "GEORGE",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "516-510-3713",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NY",
            "license": "029855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krupa Patel, PA-C
• Reshma Patel
• Anne Claire Pernot, DDS
• Dana Persaud
• Darcie A Phillips Sivacek
• Pro Sports Performance, Inc
• Prohealth Care Associates LLP (National Foot Care)
• Pulmonary,Criticalcare,Sleep &Internal Medicine PC
• Haseeb Qazi, CNIM, R EEG T., EP T
• Betcy Rajan, PHARMD

• Physical Therapy Clinic/Center in Garden City Park, NY
• Providers in Garden City Park, NY by specialty
• Physical Therapy Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2009; 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.