Active NPI
Toussaint Lake
- Physical Therapist
- Brooklyn, NY
National Provider Identifier
1942509419
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 0161651
- Practice address
- 309 Van Buren St
Brooklyn, NY 11221-1997 - Phone
- (718) 573-3934
- NPI assigned
- Mar 23, 2011
- Last updated
- Mar 23, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 | 0161651 | NY | Primary |
Addresses
Primary practice location
309 Van Buren St
Brooklyn, NY 11221-1997
Mailing address
309 Van Buren St
Brooklyn, NY 11221-1997
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 |
|---|---|---|---|
| 0161651 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1300838400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1300838400000",
"number": "1942509419",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "309 VAN BUREN ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112211997"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "309 VAN BUREN ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112211997",
"telephone_number": "718-573-3934"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAKE",
"first_name": "TOUSSAINT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-03-23",
"last_updated": "2011-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "0161651",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.