Nathaniel Magallon Tabo, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

041060 Issued in NY

Practice address

2712 Claflin Ave
Bronx, NY 10468-3304

Phone

(347) 860-8593

NPI assigned

Aug 16, 2022

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

Enrolled in NY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Outreach Physical and Occupational Therapy & Speech Rehabilitation, PLLC

  • Physical Therapist
  • Great Neck, NY
  • NPI 1841526399
  Medicare reassignment NPD

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

{
    "created_epoch": "1660608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1881312841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2712 CLAFLIN AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104683304",
            "telephone_number": "347-860-8593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2712 CLAFLIN AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104683304",
            "telephone_number": "347-860-8593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABO",
        "first_name": "NATHANIEL",
        "middle_name": "MAGALLON",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-16",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "041060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vafa Tabatabaie, M.D.
• Eloy Dario Tabeayo Alvarez, MD
• Jacob Taber, MD
• Nathan Bradley Taber, MD
• Ashley Tabi
• Ronald Bryan Calazan Tacandong
• Hannah Dawn Bugayong Tacastacas
• Gladys Amaku Tackie-Yarboi, NP
• Cecilia Edith Tackie, NP
• Esther Tackie, LPN

• Physical Therapist in Bronx, NY
• Providers in Bronx, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2022; 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.