Mary Rose L Custodio

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

026493-1 Issued in NY

Practice address

1508 Avenue U
Brooklyn, NY 11229-3808

Phone

(718) 376-3383

Fax

(718) 376-3385

NPI assigned

Sep 20, 2006

Last updated

Mar 10, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Caring PT Group, PLLC

  • Physical Medicine & Rehabilitation Physician
  • Newburgh, NY
  • NPI 1659896603
  Medicare reassignment
• Abundance PT P.C.

  • Physical Therapist
  • New Rochelle, NY
  • NPI 1366312845
  NPD

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236643200000",
    "number": "1740388412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1508 AVENUE U",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112293808",
            "telephone_number": "718-376-3383",
            "fax_number": "718-376-3385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1508 AVENUE U",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112293808",
            "telephone_number": "718-376-3383",
            "fax_number": "718-376-3385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSTODIO",
        "first_name": "MARY ROSE L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2009-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "026493-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dana D Cusato
• Riley Cushing, FNP-C
• Carla Cusimano, M.A.
• Brailee Custer
• Kevin Tyrone Custis, M.D.
• Custom Chemists Inc. (Davids Pharmacy LTC)
• Custom Chemists Inc. (David's Pharmacy)
• Custom Equipment Ny Inc
• Barbara Ann Cusumano
• Nicole Marie Cusumano, OTR L

• Physical Therapist in Brooklyn, NY
• Providers in Brooklyn, 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 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.