Individual provider Active NPI

Linda Patrice Kaja-Mulvena, P.T.

  • Physical Therapist
  • Glendale, NY
National Provider Identifier
1790930691
Registry record updated Nov 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
010024-1 Issued in NY
Practice address
8314 77TH Ave
Glendale, NY 11385-7705
Phone
(917) 836-7866
Fax
(718) 366-0660
NPI assigned
Nov 20, 2008
Last updated
Nov 20, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2008

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 010024-1 NY Primary
Geriatric Physical Therapist 2251G0304X 010024-1 NY
Neurology Physical Therapist 2251N0400X 010024-1 NY
Pediatric Physical Therapist 2251P0200X 010024-1 NY

Addresses

Primary practice location

8314 77TH Ave
Glendale, NY 11385-7705

Mailing address

8314 77TH Ave
Glendale, NY 11385-7705
Phone (917) 836-7866

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1227139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227139200000",
    "number": "1790930691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8314 77TH AVE",
            "city": "GLENDALE",
            "state": "NY",
            "postal_code": "113857705",
            "telephone_number": "917-836-7866",
            "fax_number": "718-366-0660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8314 77TH AVE",
            "city": "GLENDALE",
            "state": "NY",
            "postal_code": "113857705",
            "telephone_number": "917-836-7866",
            "fax_number": "718-366-0660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAJA-MULVENA",
        "first_name": "LINDA",
        "middle_name": "PATRICE",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-20",
        "last_updated": "2008-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "010024-1",
            "primary": true
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "NY",
            "license": "010024-1",
            "primary": false
        },
        {
            "code": "2251N0400X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Neurology",
            "state": "NY",
            "license": "010024-1",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NY",
            "license": "010024-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2008; 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.