Sara Anne Chan, P.T., C.F.M.T

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

026599-1 Issued in NY

Practice address

555 Goffle Rd
Suite 104
Ridgewood, NJ 07450

Phone

(201) 895-0359

Fax

(833) 312-9544

NPI assigned

Dec 29, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Sara Anne Lewis Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573776000000",
    "number": "1871659110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 GARFIELD PLACE",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074503724",
            "telephone_number": "201-895-0359",
            "fax_number": "833-312-9544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 GOFFLE RD",
            "address_2": "SUITE 104",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "07450",
            "telephone_number": "201-895-0359",
            "fax_number": "833-312-9544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "SARA",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "P.T., C.F.M.T",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-29",
        "last_updated": "2019-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA1714000",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "026599-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARA",
            "last_name": "LEWIS",
            "middle_name": "ANNE",
            "prefix": "MS.",
            "credential": "PT, CFMT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Fay A Cesarano-Caputo, RD-CDN
• Carolyn Chadwick, LMSW
• Olga Valery Chaikovsky, MS
• Corey Chan, PA-C
• Jenny Sang Chan, MD
• Breehan Kelley Chancellor, M.D.
• Daniel Char
• Charles Tsakrios Jr. M.D PA
• Susan Charles, FNP
• Joy Charnesky

• Physical Therapist in Ridgewood, NJ
• Providers in Ridgewood, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2019; 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.