St, Michael Physical Therapy PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

ST, MICHAEL PHYSICAL THERAPY PC

Practice address

710 Courtlandt Ave
Bronx, NY 10451-5055

Phone

(347) 270-1124

NPI assigned

Nov 17, 2022

Organization subpart

No

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

Authorized official

Name

Joseph Wellen, PT

Title

Provider

Phone

(201) 888-1549

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• St, Michael Physical Therapy PC Doing business as

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

{
    "created_epoch": "1668643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668643200000",
    "number": "1902515059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 COURTLANDT AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104515055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 COURTLANDT AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104515055",
            "telephone_number": "347-270-1124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST, MICHAEL PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-17",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A",
        "authorized_official_last_name": "WELLEN",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "201-888-1549",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT",
            "identifier": "1715341",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St, Michael Physical Therapy PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• 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 Nov 17, 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.