Francyl Jason Supena, PHYSICAL THERAPIST

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

041400 Issued in NY

Practice address

600 E 2ND St
Brooklyn, NY 11218-4964

Phone

(929) 371-7282

NPI assigned

Aug 24, 2022

Last updated

Aug 24, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1661299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661299200000",
    "number": "1679292585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 E 2ND ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112184964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 E 2ND ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112184964",
            "telephone_number": "929-371-7282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUPENA",
        "first_name": "FRANCYL JASON",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-24",
        "last_updated": "2022-08-24",
        "certification_date": "2022-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NY",
            "license": "041400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Laptop",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "600 E 2nd St",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112184964",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Suny Health Science Center at Brooklyn (Suny DMC@Lich-Family Practice)
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• Suny HSC at Brooklyn
• Suny-DMC
• Super Achievers Corp
• Super Care Inc
• Super Care RX Inc (Foster Maaz Pharmacy)
• Super Fast Limousine
• Super JV Inc

• Physical Therapy Clinic/Center in Brooklyn, NY
• Providers in Brooklyn, 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 Aug 24, 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.