Individual provider Active NPI

Julliya Reznik

  • Physical Therapist
  • Glendale, NY
National Provider Identifier
1740606904
Registry record updated Mar 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
034646 Issued in NY
Practice address
9060 Union Tpke Apt 10a
Glendale, NY 11385-8071
Phone
(917) 838-5105
NPI assigned
Mar 12, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 034646 NY Primary

Addresses

Primary practice location

9060 Union Tpke Apt 10a
Glendale, NY 11385-8071

Mailing address

9060 Union Tpke Apt 10a
Glendale, NY 11385-8071
Phone (917) 838-5105

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140507000984 NY Practitioner - Physical Therapist in Private Practice 1658504188 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Rehabilitation Physical Therapy Services LLCGroup PAC ID 1355395179, 226 clinicians

Practice addresses (Care Compare)

1844 2ND Ave
New York, NY 10128-3862
Phone (877) 407-3422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
034646NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehabilitation Physical Therapy Services LLC Physical Therapist CurrentSince Mar 31, 2014 Accepting new patients

Locations

7 Carnegie Plz
Cherry Hill, NJ 08003

1415 Richmond Ave
Staten Island, NY 10314
Phone (212) 475-5540

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1394582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394582400000",
    "number": "1740606904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9060 UNION TPKE APT 10A",
            "city": "GLENDALE",
            "state": "NY",
            "postal_code": "113858071",
            "telephone_number": "917-838-5105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9060 UNION TPKE APT 10A",
            "city": "GLENDALE",
            "state": "NY",
            "postal_code": "113858071",
            "telephone_number": "917-838-5105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REZNIK",
        "first_name": "JULLIYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-12",
        "last_updated": "2014-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "034646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.