Individual provider Active NPI

Robert Nici, P.T.

  • Physical Therapist
  • Woodbury, NY
National Provider Identifier
1790719060
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8355-1 Issued in NY
Practice address
195 Froehlich Farm Blvd
Woodbury, NY 11797-2928
Phone
(516) 682-0466
Fax
(516) 682-0465
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 8355-1 NY Primary

Addresses

Primary practice location

195 Froehlich Farm Blvd
Woodbury, NY 11797-2928

Mailing address

195 Froehlich Farm Blvd
Woodbury, NY 11797-2928
Phone (516) 682-0466

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8355-1NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790719060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 FROEHLICH FARM BLVD",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117972928",
            "telephone_number": "516-682-0466",
            "fax_number": "516-682-0465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 FROEHLICH FARM BLVD",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117972928",
            "telephone_number": "516-682-0466",
            "fax_number": "516-682-0465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICI",
        "first_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "8355-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.