Active NPI
Rafi Obidullah, DPT
- Physical Therapist
- Brooklyn, NY
National Provider Identifier
1720701386
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 049208-01
- Practice address
- 364 Broadway
Brooklyn, NY 11211-7354 - Phone
- (718) 701-7300
- NPI assigned
- Sep 20, 2022
- Sex
- Male
- Sole proprietor
- Yes
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 | 049208-01 | NY | Primary |
Addresses
Primary practice location
364 Broadway
Brooklyn, NY 11211-7354
Mailing address
4826 37TH St
Long Island City, NY 11101-1904
Phone (646) 945-1018
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 |
|---|---|---|---|
| 049208-01 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663632000000",
"number": "1720701386",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4826 37TH ST",
"city": "LONG ISLAND CITY",
"state": "NY",
"postal_code": "111011904",
"telephone_number": "646-945-1018"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "364 BROADWAY",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112117354",
"telephone_number": "718-701-7300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OBIDULLAH",
"first_name": "RAFI",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-09-20",
"last_updated": "2022-09-20",
"certification_date": "2022-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "049208-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.