Balboa PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

0205341 Issued in NY

Legal business name

BALBOA PT

Practice address

945 Huguenot Ave
Staten Island, NY 10312-4312

Phone

(718) 816-6500

Fax

(718) 816-4677

NPI assigned

Aug 9, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Jason P Lamendola, PT

Title

Physical Therapist

Phone

(718) 816-6500

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1312848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418169600000",
    "number": "1811276876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "945 HUGUENOT AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103124312",
            "telephone_number": "718-816-6500",
            "fax_number": "718-816-4677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "945 HUGUENOT AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103124312",
            "telephone_number": "718-816-6500",
            "fax_number": "718-816-4677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALBOA PT",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-09",
        "last_updated": "2014-12-10",
        "status": "A",
        "authorized_official_last_name": "LAMENDOLA",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "718-816-6500",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "0205341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sushila Balakrishnan, M.D.
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• Snizhana Balanyuk
• Maria Antonette Balao, PT
• Asvini Balasubramaniam, MD
• Alexa Leigh Baldassano, AGNP-BC
• Jeanette D. Baldassano, PH.D.
• Kelly Baldassano
• Rebekah Baldini
• Stefanie Baldovin

• Physical Therapist in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2014; 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.