Active NPI
Charo Balagtas Bodiongan
- Physical Therapist
- Clifton, NJ
National Provider Identifier
1891746038
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 40QA00960400
- Practice address
- 45 E Madison Ave
Clifton, NJ 07011-2323 - Phone
- (973) 931-1717
- NPI assigned
- May 12, 2006
- Sex
- Female
- 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 | 40QA00960400 | NJ | Primary |
Addresses
Primary practice location
45 E Madison Ave
Clifton, NJ 07011-2323
Mailing address
109 Birch St
Bloomfield, NJ 07003-4017
Phone (973) 652-8959
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40QA00960400 | NJ | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563408000000",
"number": "1891746038",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 BIRCH ST",
"city": "BLOOMFIELD",
"state": "NJ",
"postal_code": "070034017",
"telephone_number": "973-652-8959",
"fax_number": "973-582-9288"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "45 E MADISON AVE",
"city": "CLIFTON",
"state": "NJ",
"postal_code": "070112323",
"telephone_number": "973-931-1717"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BODIONGAN",
"first_name": "CHARO",
"middle_name": "BALAGTAS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-12",
"last_updated": "2019-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QA00960400",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clifton, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.