Individual provider Active NPI

Edward Joseph Haddican, PT, DPT, OCS

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1740650944
Registry record updated Sep 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
039058 Issued in NY
Practice address
71 Carroll St
Brooklyn, NY 11231-2767
Phone
(718) 797-9797
Fax
(718) 797-9796
NPI assigned
Sep 30, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2019

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 039058 NY Primary

Addresses

Primary practice location

71 Carroll St
Brooklyn, NY 11231-2767

Mailing address

7 Hawk St
Pearl River, NY 10965-2811
Phone (845) 642-9834

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210601000094 NC Practitioner - Physical Therapist in Private Practice 3577894666 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 2

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": "1443571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569196800000",
    "number": "1740650944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 HAWK ST",
            "city": "PEARL RIVER",
            "state": "NY",
            "postal_code": "109652811",
            "telephone_number": "845-642-9834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 CARROLL ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112312767",
            "telephone_number": "718-797-9797",
            "fax_number": "718-797-9796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADDICAN",
        "first_name": "EDWARD",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "PT, DPT, OCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-30",
        "last_updated": "2019-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "039058",
            "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 23, 2019; 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.