Individual provider Active NPI

Liana Goldyuk, P.T

  • Physical Therapist
  • Staten Island, NY
National Provider Identifier
1811154115
Registry record updated Apr 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
027521-1 Issued in NY
Practice address
25 Seaside LN
Staten Island, NY 10305-4753
Phone
(917) 754-0238
Fax
(718) 382-0231
NPI assigned
May 22, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2011

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 027521-1 NY Primary

Addresses

Primary practice location

25 Seaside LN
Staten Island, NY 10305-4753

Mailing address

25 Seaside LN
Staten Island, NY 10305-4753
Phone (917) 754-0238

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
027521-1NYMDPhysical Therapist
027521NYMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1211414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303257600000",
    "number": "1811154115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 SEASIDE LN",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103054753",
            "telephone_number": "917-754-0238",
            "fax_number": "718-382-0231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 SEASIDE LN",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103054753",
            "telephone_number": "917-754-0238",
            "fax_number": "718-382-0231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDYUK",
        "first_name": "LIANA",
        "name_prefix": "Ms.",
        "credential": "P.T",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-22",
        "last_updated": "2011-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "027521-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2011; 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.