NPIMap

Organization Active NPI

Body and Balance Physical Therapy,PC

Doing business as Millennium Physical Therapy & Sports Medicine

  • Physical Therapy Clinic/Center
  • Flushing, NY
National Provider Identifier
1790837953
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
62028308 Issued in NY
Legal business name
BODY AND BALANCE PHYSICAL THERAPY,PC
Doing business as
Millennium Physical Therapy & Sports Medicine
Practice address
19413 Northern Blvd
Flushing, NY 11358-3032
Phone
(718) 428-9369
Fax
(718) 423-9825
NPI assigned
Jan 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Theodosios Neamonitis, DPTNPI 1396794228
Title
President
Phone
(718) 428-9369

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 62028308 NY Primary

Addresses

Primary practice location

19413 Northern Blvd
Flushing, NY 11358-3032

Mailing address

22415 Horace Harding Expy
Oakland Gardens, NY 11364-2301
Phone (646) 577-5661

Other identifiers 1

IdentifierTypeStateIssuer
62028308OtherNYLICENSE

Other names 1

  • Millennium Physical Therapy & Sports Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Body in Balance Physical Therapy PC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the 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.

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790837953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22415 HORACE HARDING EXPY",
            "city": "OAKLAND GARDENS",
            "state": "NY",
            "postal_code": "113642301",
            "telephone_number": "646-577-5661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19413 NORTHERN BLVD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113583032",
            "telephone_number": "718-428-9369",
            "fax_number": "718-423-9825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BODY AND BALANCE PHYSICAL THERAPY,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NEAMONITIS",
        "authorized_official_first_name": "THEODOSIOS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-428-9369",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NY",
            "license": "62028308",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "62028308",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Millennium Physical Therapy & Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.