Gemma T. Pedraza-Hetalia, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01161000 Issued in NJ

Practice address

1 Degraw Ave
Teaneck, NJ 07666-4000

Phone

(201) 353-9000

Fax

(201) 530-0002

NPI assigned

Apr 10, 2008

Last updated

Apr 10, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1207785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207785600000",
    "number": "1952574956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DEGRAW AVE",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076664000",
            "telephone_number": "201-353-9000",
            "fax_number": "201-530-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 DEGRAW AVE",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076664000",
            "telephone_number": "201-353-9000",
            "fax_number": "201-530-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDRAZA-HETALIA",
        "first_name": "GEMMA",
        "middle_name": "T.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-10",
        "last_updated": "2008-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01161000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keisha Pearson, LSW
• Pavani Peddi, MD
• Pedi-Care Corp (Pedicare Orthotics & Prosthetics)
• Pediatric Occupational Therapy Services, LLC
• Pediatrics on Demand
• Robert Michael Peller, PH.D.
• David J Penn, P.A
• Donna L Perdew, PT
• Ivonne R Pereira, APN
• Francisca Mercedes Perez, LCSW-R

• Physical Therapist in Teaneck, NJ
• Providers in Teaneck, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; 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.