Individual provider Active NPI

Guendolyn Parreno-Partisala, PHYSICAL THERAPIST

  • Physical Therapist
  • Deer Park, NY
National Provider Identifier
1831405620
Registry record updated Aug 31, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
019988-2 Issued in NY
Practice address
124 W 24TH St
Deer Park, NY 11729-4820
Phone
(631) 839-1459
NPI assigned
Aug 31, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2010

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 019988-2 NY Primary

Addresses

Primary practice location

124 W 24TH St
Deer Park, NY 11729-4820

Mailing address

124 W 24TH St
Deer Park, NY 11729-4820
Phone (631) 839-1459

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

State licenses

LicenseStateTypeSpecialty
019988-2NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
GBP PT PC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1283212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283212800000",
    "number": "1831405620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 W 24TH ST",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117294820",
            "telephone_number": "631-839-1459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 W 24TH ST",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117294820",
            "telephone_number": "631-839-1459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARRENO-PARTISALA",
        "first_name": "GUENDOLYN",
        "name_prefix": "Mrs.",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-31",
        "last_updated": "2010-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "019988-2",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deer Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2010; 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.