NPIMap

Organization Active NPI

180Physiotherapy PT PLLC

  • Physical Therapist
  • Forest Hills, NY
National Provider Identifier
1770142408
Registry record updated Jun 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
180PHYSIOTHERAPY PT PLLC
Practice address
6723 Dartmouth St Apt 3
Forest Hills, NY 11375-4052
Phone
(347) 599-6099
NPI assigned
Jun 6, 2019
Last updated
Jun 6, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2019

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

Authorized official

Name
Mr. Boris AvezovNPI 1336690361
Title
PT/Owner
Phone
(347) 599-6099

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

6723 Dartmouth St Apt 3
Forest Hills, NY 11375-4052

Mailing address

6723 Dartmouth St Apt 3
Forest Hills, NY 11375-4052
Phone (347) 599-6099

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1559779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559779200000",
    "number": "1770142408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6723 DARTMOUTH ST APT 3",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754052",
            "telephone_number": "347-599-6099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6723 DARTMOUTH ST APT 3",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754052",
            "telephone_number": "347-599-6099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "180PHYSIOTHERAPY PT PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-06",
        "last_updated": "2019-06-06",
        "status": "A",
        "authorized_official_last_name": "AVEZOV",
        "authorized_official_first_name": "BORIS",
        "authorized_official_title_or_position": "PT/OWNER",
        "authorized_official_telephone_number": "347-599-6099",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.