Fresh Pond Physical Therapy, P.C

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

0363571 Issued in NY

Legal business name

FRESH POND PHYSICAL THERAPY, P.C

Practice address

6805 Fresh Pond Rd
Ridgewood, NY 11385-5200

Phone

(718) 456-2545

Fax

(718) 559-6784

NPI assigned

Jul 1, 2015

Organization subpart

Yes

Parent organization

FRESH POND PHYSICAL THERAPY, P.CAs reported in NPPES

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

Authorized official

Name

Mr. Dexter C Bongato, PT

Title

Staff Physical Therapist

Phone

(718) 456-2545

Specialties & licenses 1

Addresses

Part of

Fresh Pond Physical Therapy PC

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Fresh Pond Physical Therapy, P.C

  • Physical Therapy Clinic/Center
  • Ridgewood, NY
  • NPI 1508844036
  NPPES parent name

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

{
    "created_epoch": "1435708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437350400000",
    "number": "1962885491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6805 FRESH POND RD",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "113855200",
            "telephone_number": "718-456-2545",
            "fax_number": "718-559-6784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6805 FRESH POND RD",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "113855200",
            "telephone_number": "718-456-2545",
            "fax_number": "718-559-6784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRESH POND PHYSICAL THERAPY, P.C",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRESH POND PHYSICAL THERAPY, P.C",
        "enumeration_date": "2015-07-01",
        "last_updated": "2015-07-20",
        "status": "A",
        "authorized_official_last_name": "BONGATO",
        "authorized_official_first_name": "DEXTER",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "STAFF PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "718-456-2545",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NY",
            "license": "0363571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Forest Medcare P.C.
• Jessica Lynn Forste, M.A., CCC-SLP
• Freedom Star Medical Supplies Inc
• Fresh Pond Physical Therapy Greenpoint, P.C
• Fresh Pond Physical Therapy, P.C
• Fresh Pond Podiatry PLLC
• Fresh Pond RX Inc
• Fresh Smiles PLLC
• Friendly Connections Inc
• Sreenivasa R Gade II

• Physical Therapy Clinic/Center in Ridgewood, NY
• Providers in Ridgewood, 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 Jul 20, 2015; 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.