Long Island City Physical Therapy, PLLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

022838-1 Issued in NY

Legal business name

LONG ISLAND CITY PHYSICAL THERAPY, PLLC

Practice address

1043 48TH Ave
Long Island City, NY 11101-5607

Phone

(718) 943-7100

Fax

(718) 786-9798

NPI assigned

Sep 15, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Patricia Ann Brancale, M.S.P.T.

Title

Director Physical Therapy

Phone

(718) 943-7100

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269216000000",
    "number": "1699871780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1043 48TH AVE",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111015607",
            "telephone_number": "718-943-7100",
            "fax_number": "718-786-9798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1043 48TH AVE",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111015607",
            "telephone_number": "718-943-7100",
            "fax_number": "718-786-9798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG ISLAND CITY PHYSICAL THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-15",
        "last_updated": "2010-03-22",
        "status": "A",
        "authorized_official_last_name": "BRANCALE",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "DIRECTOR PHYSICAL THERAPY",
        "authorized_official_telephone_number": "718-943-7100",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.S.P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "022838-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH PROVIDER ID",
            "identifier": "11452885",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Long Island City, NY
• Providers in Long Island City, 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 Mar 22, 2010; 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.