Individual provider Active NPI

Lean Carlo P Romualdo

  • Physical Therapy Assistant
  • New York, NY
National Provider Identifier
1972465581
Registry record updated Dec 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
008034-01 Issued in NY
Practice address
520 W 218TH St
New York, NY 10034-1020
Phone
(212) 304-1755
Fax
(212) 304-4308
NPI assigned
Dec 2, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 225200000X 008034-01 NY Primary

Addresses

Primary practice location

520 W 218TH St
New York, NY 10034-1020

Mailing address

34 S Harrison Ave
Congers, NY 10920-2212
Phone (845) 729-1702

Other practice location 1

354 Fort Washington Ave
New York, NY 10033-6834
Phone (646) 869-0599 ext. 90599

Other practice location 2

4211 Broadway
New York, NY 10033-3747
Phone (646) 707-0469

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
008034-01NYMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1764633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764633600000",
    "number": "1972465581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 S HARRISON AVE",
            "city": "CONGERS",
            "state": "NY",
            "postal_code": "109202212",
            "telephone_number": "845-729-1702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 W 218TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100341020",
            "telephone_number": "212-304-1755",
            "fax_number": "212-304-4308"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "354 Fort Washington Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100336834",
            "country_code": "US",
            "telephone_number": "646-869-0599 x90599",
            "fax_number": "212-304-4308",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4211 Broadway",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100333747",
            "country_code": "US",
            "telephone_number": "646-707-0469",
            "fax_number": "212-304-4308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROMUALDO",
        "first_name": "LEAN CARLO",
        "middle_name": "P",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-12-02",
        "last_updated": "2025-12-02",
        "certification_date": "2025-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "008034-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2025; 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.