Outstanding PT PC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

OUTSTANDING PT PC

Practice address

5718 Woodside Ave
Woodside, NY 11377-3415

Phone

(646) 361-8420

NPI assigned

Apr 19, 2021

Last updated

Apr 19, 2021By 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

Mr. Bonifacio Ober, PT

Title

President

Phone

(646) 361-8420

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1618790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618790400000",
    "number": "1861073132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8374 TALBOT ST APT 1E",
            "city": "KEW GARDENS",
            "state": "NY",
            "postal_code": "114153543",
            "telephone_number": "646-361-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5718 WOODSIDE AVE",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113773415",
            "telephone_number": "646-361-8420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUTSTANDING PT PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-19",
        "last_updated": "2021-04-19",
        "certification_date": "2021-04-19",
        "status": "A",
        "authorized_official_last_name": "OBER",
        "authorized_official_first_name": "BONIFACIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "646-361-8420",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Clinic/Center in Woodside, NY
• Providers in Woodside, 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 Apr 19, 2021; 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.