Breakaway Physical Therapy PLLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

031329-1 Issued in NY

Legal business name

BREAKAWAY PHYSICAL THERAPY PLLC

Practice address

212 W 91St St Apt 425
New York, NY 10024-1333

Phone

(646) 484-1410

NPI assigned

Feb 24, 2015

Last updated

Apr 16, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Alan Snyder, DPTNPI 1487817862

Title

Physical Therapist

Phone

(646) 484-1410

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Alan Snyder

  • Physical Therapist
  • Baltimore, MD
  • NPI 1487817862

  NJ

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1424736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555372800000",
    "number": "1821480021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 W 91ST ST APT 425",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100241333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 W 91ST ST APT 425",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100241333",
            "telephone_number": "646-484-1410"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "212 W 91st St",
            "address_2": "suite 1507",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100241327",
            "country_code": "US",
            "telephone_number": "347-668-9651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BREAKAWAY PHYSICAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-24",
        "last_updated": "2019-04-16",
        "status": "A",
        "authorized_official_last_name": "SNYDER",
        "authorized_official_first_name": "ALAN",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "646-484-1410",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "031329-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Brea, D.C.
• Jannis Raye Brea
• Laura Brea
• Jewel Breadmore, PA-C
• Devin Michael Bready, MD
• Sarah Breakstone, DPM
• Breast Reconstruction Center of New Jersey
• Breastfeeding Support, Inc.
• Breathe Bloom Mental Health Counseling PLLC
• Breathe Licensed Clinical Social Work Services

• Physical Therapist in New York, NY
• Providers in New York, 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 Apr 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.