Robin Kim Bandura, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT013917L Issued in PA

Practice address

12 W Willow Grove Ave
Philadelphia, PA 19118-3952

Phone

(215) 450-8717

NPI assigned

Jul 19, 2005

Sex

Female

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)

Enrolled

State licenses

Practice roles

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.

• Fitlife Fitness & Aquatics, Incorporated

  • Physical Therapy Clinic/Center
  • Philadelphia, PA
  • NPI 1124105473

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654128000000",
    "number": "1881693232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 W WILLOW GROVE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191183952",
            "telephone_number": "215-450-8717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 W WILLOW GROVE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191183952",
            "telephone_number": "215-450-8717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANDURA",
        "first_name": "ROBIN",
        "middle_name": "KIM",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-19",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT013917L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roger A Band, MD
• Stephen E Band, DMD
• Pouya Bandegi
• Paul Joseph Bandini, MD
• Rebecca Sydney Bandler, NP
• Natali Vanina Baner, MD
• Anirban Banerjee, MD
• Audreesh Banerjee, MD
• Maalika Banerjee, MD, MPH
• Shubhasree Banerjee, MD

• Physical Therapist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2022; 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.