Anthony Peter Izurieta, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

40QB00220700 Issued in NJ

Practice address

2300 Hamilton Ave
Hamilton, NJ 08619-3007

Phone

(609) 588-5823

Fax

(609) 588-5580

NPI assigned

Aug 19, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1219104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219104000000",
    "number": "1861649006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 GRACE ST",
            "address_2": "2ND FLOOR",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070034719",
            "telephone_number": "973-634-0633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 HAMILTON AVE",
            "city": "HAMILTON",
            "state": "NJ",
            "postal_code": "086193007",
            "telephone_number": "609-588-5823",
            "fax_number": "609-588-5580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IZURIETA",
        "first_name": "ANTHONY",
        "middle_name": "PETER",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-19",
        "last_updated": "2008-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NJ",
            "license": "40QB00220700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Assistant in Hamilton, NJ
• Providers in Hamilton, NJ by specialty
• Physical Therapy Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2008; 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.