Organization Active NPI

Manjoorsa Physical Therapy P.C.

  • Physical Therapy Clinic/Center
  • Elmhurst, NY
National Provider Identifier
1962799361
Registry record updated Jan 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
027648 Issued in NY
Legal business name
MANJOORSA PHYSICAL THERAPY P.C.
Practice address
8411 Queens Blvd
Elmhurst, NY 11373-3098
Phone
(347) 968-8304
NPI assigned
Jul 6, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2020

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

Authorized official

Name
Al ManjoorsaNPI 1851510630
Title
Physical Therapist/ Director
Phone
(347) 968-8304

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 027648 NY Primary

Addresses

Primary practice location

8411 Queens Blvd
Elmhurst, NY 11373-3098

Mailing address

8411 Queens Blvd
Elmhurst, NY 11373-3098
Phone (347) 968-8304

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120201000503 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7719144831 Receives reassigned benefits from 1 practitioner
Practice locations: Elmhurst, NY

National Provider Directory

National Provider Directory

Locations

14232 38TH Ave 2a
2A
Flushing, NY 11354

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579219200000",
    "number": "1962799361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8411 QUEENS BLVD",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113733098",
            "telephone_number": "347-968-8304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8411 QUEENS BLVD",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113733098",
            "telephone_number": "347-968-8304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANJOORSA PHYSICAL THERAPY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-06",
        "last_updated": "2020-01-17",
        "certification_date": "2020-01-17",
        "status": "A",
        "authorized_official_last_name": "MANJOORSA",
        "authorized_official_first_name": "AL",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST/ DIRECTOR",
        "authorized_official_telephone_number": "347-968-8304"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NY",
            "license": "027648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.