Active NPI
Rey Mark Lizen
- Physical Therapist
- Forest Hills, NY
National Provider Identifier
1891332813
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 042155
- Practice address
- 6970 Grand Central Pkwy
Forest Hills, NY 11375-3949 - Phone
- (718) 263-4600
- NPI assigned
- Dec 9, 2019
- Sex
- Male
- 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 | 042155 | NY | Primary |
Addresses
Primary practice location
6970 Grand Central Pkwy
Forest Hills, NY 11375-3949
Mailing address
8722 51St Ave Apt 2E
Elmhurst, NY 11373-4183
Phone (646) 479-8555
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 042155 | NY | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1575849600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1575849600000",
"number": "1891332813",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8722 51ST AVE APT 2E",
"city": "ELMHURST",
"state": "NY",
"postal_code": "113734183",
"telephone_number": "646-479-8555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6970 GRAND CENTRAL PKWY",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113753949",
"telephone_number": "718-263-4600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIZEN",
"first_name": "REY MARK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-12-09",
"last_updated": "2019-12-09",
"certification_date": "2019-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "042155",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forest Hills, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 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.