Active NPI
Renan Cuyson Pablo, RPT
- Physical Therapist
- Edison, NJ
National Provider Identifier
1689926925
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 40QA01465700
- Practice address
- 100 Metroplex Dr Ste 102
Edison, NJ 08817-2684 - Phone
- (732) 572-9600
- NPI assigned
- Oct 10, 2012
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 40QA01465700 | NJ | Primary |
Addresses
Primary practice location
100 Metroplex Dr Ste 102
Edison, NJ 08817-2684
Mailing address
511 Banks Rd Apt 8a
Jasper, AL 35504-8157
Phone (205) 522-2488
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 |
|---|---|---|---|
| 40QA01465700 | NJ | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1349827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349827200000",
"number": "1689926925",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "511 BANKS RD APT 8A",
"city": "JASPER",
"state": "AL",
"postal_code": "355048157",
"telephone_number": "205-522-2488"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 METROPLEX DR STE 102",
"city": "EDISON",
"state": "NJ",
"postal_code": "088172684",
"telephone_number": "732-572-9600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PABLO",
"first_name": "RENAN",
"middle_name": "CUYSON",
"name_prefix": "Mr.",
"credential": "RPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-10-10",
"last_updated": "2012-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QA01465700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edison, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.