Wall Street Ny Physical Therapy PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

WALL STREET NY PHYSICAL THERAPY PC

Practice address

26 Broadway Ste 931
New York, NY 10004-1710

Phone

(646) 886-8687

Fax

(212) 656-1091

NPI assigned

Jan 5, 2021

Organization subpart

No

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

Authorized official

Name

Sanchu Chacko

Title

Owner

Phone

(646) 886-8687

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1609804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662422400000",
    "number": "1962090084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 CENTER DR",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110402302",
            "telephone_number": "646-886-8687",
            "fax_number": "212-656-1091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 BROADWAY STE 931",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100041710",
            "telephone_number": "646-886-8687",
            "fax_number": "212-656-1091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALL STREET NY PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-05",
        "last_updated": "2022-09-06",
        "certification_date": "2021-09-29",
        "status": "A",
        "authorized_official_last_name": "CHACKO",
        "authorized_official_first_name": "SANCHU",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "646-886-8687"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wall Street Foot Group
• Wall Street Medical
• Wall Street Medical PC
• Wall Street Medical PC
• Wall Street Medicine PLLC
• Wall Street Physical Medicine & Rehabilitation, P.C.
• Wall Street Physical Therapy PC
• Wall Street Physician PLLC
• Wall Street Podiatry Care PC
• Wall Street Podiatry PC

• Physical Therapist in New York, NY
• Providers in New York, 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 Sep 6, 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.