Active NPI
Ryan Fayluga Acolicol, PT
- Physical Therapist
- Leonia, NJ
National Provider Identifier
1679946750
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 038034-1
- Practice address
- 55 Lakeview Ave Apt a
Leonia
Leonia, NJ 07605-3102 - Phone
- (917) 691-5201
- NPI assigned
- Nov 11, 2015
- Last updated
- Nov 11, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 038034-1 | NY | Primary |
| Physical Therapist | 225100000X | PT024806 | PA | |
| Physical Therapist | 225100000X | 0019900 | ZZ |
Addresses
Primary practice location
55 Lakeview Ave Apt a
Leonia
Leonia, NJ 07605-3102
Mailing address
349 Brillantes Subdivision, Gov. Ramos Street
Sta. Maria
Zamboanga City, ZAMBOANGA DEL SUR 7000
PH
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NA | Other | NA |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 038034-1 | NY | MD | Physical Therapist |
| PT024806 | PA | MD | Physical Therapist |
| 0019900 | ZZ | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1447200000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447200000000",
"number": "1679946750",
"addresses": [
{
"country_code": "PH",
"country_name": "Philippines",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "349 BRILLANTES SUBDIVISION, GOV. RAMOS STREET",
"address_2": "STA. MARIA",
"city": "ZAMBOANGA CITY",
"state": "ZAMBOANGA DEL SUR",
"postal_code": "7000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 LAKEVIEW AVE APT A",
"address_2": "LEONIA",
"city": "LEONIA",
"state": "NJ",
"postal_code": "076053102",
"telephone_number": "917-691-5201"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ACOLICOL",
"first_name": "RYAN",
"middle_name": "FAYLUGA",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-11-11",
"last_updated": "2015-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "038034-1",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT024806",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ZZ",
"license": "0019900",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NA",
"identifier": "NA",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Leonia, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.