Active NPI
Aileen Joy Maravilla Lagunilla, PT
- Physical Therapist
- New York, NY
National Provider Identifier
1861441669
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 012688-1
- Practice address
- 122 E 23Rd St
New York, NY 10010-4516 - Phone
- (212) 677-7400
- Fax
- (212) 529-2071
- NPI assigned
- May 9, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 012688-1 | NY | Primary |
Addresses
Primary practice location
122 E 23Rd St
New York, NY 10010-4516
Mailing address
2113 Salisbury Park Dr
Westbury, NY 11590-6313
Phone (516) 312-6474
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 012688-1 | NY | MD | Physical Therapist |
| 012688 | NY | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| United Cerebral Palsy of New York City Inc | Current | Accepting new patients |
Locations
175 Lawrence Ave
Brooklyn, NY 11230
Phone (718) 436-7600
80 Maiden Ln
Fl 12
New York, NY 10038
122 E 23rd St
New York, NY 10010
Phone (718) 993-3458
80 Maiden Ln
Fl 8
New York, NY 10038
Phone (347) 971-2368
Organizations & group practices 2
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.
-
- Rehabilitation Clinic/Center
- New York, NY
- NPI 1730302019
-
- Intellectual & Developmental Disabilities Psychologist
- New York, NY
- NPI 1033873153
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1861441669",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2113 SALISBURY PARK DR",
"city": "WESTBURY",
"state": "NY",
"postal_code": "115906313",
"telephone_number": "516-312-6474"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "122 E 23RD ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100104516",
"telephone_number": "212-677-7400",
"fax_number": "212-529-2071"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAGUNILLA",
"first_name": "AILEEN JOY",
"middle_name": "MARAVILLA",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "012688-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.