Dynasty Physical Therpay and Rehabilitation, PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501011025 Issued in MI

Legal business name

DYNASTY PHYSICAL THERPAY AND REHABILITATION, PC

Practice address

3800 Woodward Ave Ste 1100
Detroit, MI 48201-2062

Phone

(313) 832-8008

NPI assigned

Oct 31, 2007

Organization subpart

No

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

Authorized official

Name

Tariq J. Siddiqi, PT

Title

Owner

Phone

(313) 832-8008

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Raheelah Khan

  • Occupational Therapist
  • Detroit, MI
  • NPI 1861444242
  NPD (past)

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

{
    "created_epoch": "1193788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193788800000",
    "number": "1902085418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 WOODWARD AVE STE 1100",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012062",
            "telephone_number": "313-832-8008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 WOODWARD AVE STE 1100",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012062",
            "telephone_number": "313-832-8008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNASTY PHYSICAL THERPAY AND REHABILITATION, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-31",
        "last_updated": "2007-10-31",
        "status": "A",
        "authorized_official_last_name": "SIDDIQI",
        "authorized_official_first_name": "TARIQ",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-832-8008",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501011025",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201006743",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tanya Dye, MSW, LLMSW
• Alexander James-Robert Dyke, DMD
• Dynamic Care Group LLC
• Dynamic Rehab Services Inc
• Dynamic Teaching
• Dynasty Senior Center
• Casandra Dysard
• Malgorzata Dziadkowiec
• Patricia Dzieciolowski, MSW,CSW
• Elberta Dziobak, CNM

• Physical Therapist in Detroit, MI
• Providers in Detroit, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2007; 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.