Active Delmar Physical Therapy PLLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

ACTIVE DELMAR PHYSICAL THERAPY PLLC

Practice address

333 Delaware Ave
Delmar, NY 12054-1902

Phone

(301) 526-2499

NPI assigned

May 19, 2021

Organization subpart

No

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

Authorized official

Name

Kelly ChangNPI 1467765131

Title

Owner

Phone

(301) 526-2499

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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.

• Kelly Moran Chang, DPT

  • Physical Therapist
  • Clifton Park, NY
  • NPI 1467765131
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1621382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621382400000",
    "number": "1831763242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "357 DELAWARE AVE UNIT 173",
            "city": "DELMAR",
            "state": "NY",
            "postal_code": "120546207",
            "telephone_number": "301-526-2499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 DELAWARE AVE",
            "city": "DELMAR",
            "state": "NY",
            "postal_code": "120541902",
            "telephone_number": "301-526-2499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE DELMAR PHYSICAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-19",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-18",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-526-2499"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara Abba, MS, RD, CNSC
• Cathryn P Abbey, CCC-SLP
• Thomas H Abele, DMD FAGD
• Janet Marie Aguirre, CCC-SLP
• Albany Medical College
• Lorien Albertson, MHC
• All Speak Speech Therapy, PLLC
• Lucille Anne Allegretti-Freeman, LCSW-R

• Physical Therapy Clinic/Center in Delmar, NY
• Providers in Delmar, NY by specialty
• Physical Therapy Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2021; 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.