Liesly Guimaray Altamirano

Individual provider Active NPI Physical Therapist · Corona, NY

NPI 1972998656 · NPPES record last updated Jun 17, 2021

Key facts

NPI
1972998656
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
034565 (NY)
Practice address
3717 111TH St Apt 2E
Corona, NY 11368-3816
Phone
(917) 434-6357
NPI assigned
Mar 31, 2015
Sex
Female
Sole proprietor
Yes

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20161115001263 NY Practitioner - Physical Therapist in Private Practice 3476832460 Reassigns benefits to 4 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Esd PT OT & SLP PLLC Physical Therapist Current
since May 15, 2024
Accepting new patients
Link Home Therapy Services of Ny-PT OT SLP PLLC Current
since May 1, 2024
Accepting new patients
Core Physical Therapy Services PC Physical Therapist Current
since Jun 1, 2022
Accepting new patients

Locations

180 Sylvan Ave
Ste 4
Englewood Cliffs, NJ 07632
Phone (347) 841-8943

2632 Atlantic Ave
Brooklyn, NY 11207
Phone (718) 473-3803

2003 Coney Island Ave
Brooklyn, NY 11223
Phone (347) 394-1600

475 Northern Blvd
Ste 37
Great Neck, NY 11021
Phone (516) 344-0023

108 S Franklin Ave
Ste 10
Valley Stream, NY 11580

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 034565 NY Yes

Addresses

Primary practice location

3717 111TH St Apt 2E
Corona, NY 11368-3816

Mailing address

3213 Hamilton Way
New Windsor, NY 12553-4957
Phone (917) 434-6357

Other names

  • Ms. Liesly Relano Guimaray Professional name

Other providers in Corona, NY

All providers in Corona, NY · Physical Therapist in New York

Sources for this page

Verify at the official NPI Registry.