NPIMap

Organization Active NPI

Age Actively Physical Therapy, P.C.

  • Physical Therapist
  • North Baldwin, NY
National Provider Identifier
1790116549
Registry record updated Dec 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
017711-1 Issued in NY
Legal business name
AGE ACTIVELY PHYSICAL THERAPY, P.C.
Practice address
1633 Westervelt Ave
North Baldwin, NY 11510-1650
Phone
(516) 343-6195
Fax
(516) 208-5005
NPI assigned
Dec 4, 2013
Last updated
Dec 4, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2013

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

Authorized official

Name
Mr. Edgar Joseph Biazon, PTNPI 1104177153
Title
President
Phone
(516) 343-6195

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 Therapist 225100000X 017711-1 NY Primary

Addresses

Primary practice location

1633 Westervelt Ave
North Baldwin, NY 11510-1650

Mailing address

1633 Westervelt Ave
North Baldwin, NY 11510-1650
Phone (516) 343-6195

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": "1386115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386115200000",
    "number": "1790116549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1633 WESTERVELT AVE",
            "city": "NORTH BALDWIN",
            "state": "NY",
            "postal_code": "115101650",
            "telephone_number": "516-343-6195",
            "fax_number": "516-208-5005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1633 WESTERVELT AVE",
            "city": "NORTH BALDWIN",
            "state": "NY",
            "postal_code": "115101650",
            "telephone_number": "516-343-6195",
            "fax_number": "516-208-5005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGE ACTIVELY PHYSICAL THERAPY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-04",
        "last_updated": "2013-12-04",
        "status": "A",
        "authorized_official_last_name": "BIAZON",
        "authorized_official_first_name": "EDGAR",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-343-6195",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "017711-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Baldwin, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2013; 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.