Active NPI
Carly Costanza, MSPT
- Geriatric Physical Therapist
- Rochester, NY
National Provider Identifier
1700101201
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Physical Therapist
- License
- 027223
- Practice address
- 1175 Monroe Ave
Rochester, NY 14610 - Phone
- (585) 275-1000
- Fax
- (585) 275-1100
- NPI assigned
- Mar 29, 2010
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Geriatric Physical Therapist | 2251G0304X | 027223 | NY | Primary |
Addresses
Primary practice location
1175 Monroe Ave
Rochester, NY 14610
Mailing address
100 Willow Creek Lane
Rochester, NY 14622
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 |
|---|---|---|---|
| 027223 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1269820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1269820800000",
"number": "1700101201",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 WILLOW CREEK LANE",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "14622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1175 MONROE AVE",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "14610",
"telephone_number": "585-275-1000",
"fax_number": "585-275-1100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COSTANZA",
"first_name": "CARLY",
"credential": "MSPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-03-29",
"last_updated": "2010-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "2251G0304X",
"taxonomy_group": "",
"desc": "Physical Therapist, Geriatrics",
"state": "NY",
"license": "027223",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rochester, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 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.