Medispa One Ny Plaza LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

MEDISPA ONE NY PLAZA LLC

Doing business as

TheMediSpa

Practice address

1 New York PLZ
Concourse Level, Whitehall Street
New York, NY 10004-1901

Phone

(646) 918-6883

Fax

(646) 737-6883

NPI assigned

Jun 16, 2015

Organization subpart

No

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

Authorized official

Name

Richard Sansaricq

Title

Managing Member/Ceo

Phone

(917) 907-1546

Specialties & licenses 1

Addresses

Other names 1

• TheMediSpa Doing business as

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

{
    "created_epoch": "1434412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477958400000",
    "number": "1962883900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 NEW YORK PLZ",
            "address_2": "CONCOURSE LEVEL, WHITEHALL STREET",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100041901",
            "telephone_number": "646-918-6883",
            "fax_number": "646-737-6883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 NEW YORK PLZ",
            "address_2": "CONCOURSE LEVEL, WHITEHALL STREET",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100041901",
            "telephone_number": "646-918-6883",
            "fax_number": "646-737-6883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDISPA ONE NY PLAZA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-16",
        "last_updated": "2016-11-01",
        "status": "A",
        "authorized_official_last_name": "SANSARICQ",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "MANAGING MEMBER/CEO",
        "authorized_official_telephone_number": "917-907-1546"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TheMediSpa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Samuel Medina
• Vivian M Medina, LCSW
• Sophia Medinsky, M.S., R.D., C.D.N.
• Amit Mediratta, M.D.
• Medirootz Medical Group
• Samantha Meditz
• Ben Medley
• Andrew Blake Medlin, PT
• Barbara Medlin, NP
• Schileen Judith Helen Medlock

• Physical Therapy Clinic/Center in New York, NY
• Providers in New York, NY by specialty
• Physical Therapy Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2016; 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.