Organization Active NPI

Professional Orthopedic and Sports Physical Therapy, P.C.

  • Physical Therapist
  • New York, NY
National Provider Identifier
1982088134
Registry record updated Mar 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY, P.C.
Practice address
132 W 96TH St
Suite 1a
New York, NY 10025-6418
Phone
(212) 249-2758
Fax
(212) 249-2506
NPI assigned
Jul 17, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2018

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

Authorized official

Name
Leticia Pabellon
Title
VP of Administrative Operations
Phone
(516) 321-2447

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

132 W 96TH St
Suite 1a
New York, NY 10025-6418

Mailing address

576 Broadhollow Rd
Melville, NY 11747-5002
Phone (631) 359-5859

National Provider Directory

National Provider Directory

Locations

132 W 96th St
Ste 1A
New York, NY 10025
Phone (212) 249-2506

NPI Registry JSON

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

{
    "created_epoch": "1437091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522281600000",
    "number": "1982088134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 BROADHOLLOW RD",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117475002",
            "telephone_number": "631-359-5859",
            "fax_number": "631-396-0865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 W 96TH ST",
            "address_2": "SUITE 1A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100256418",
            "telephone_number": "212-249-2758",
            "fax_number": "212-249-2506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-17",
        "last_updated": "2018-03-29",
        "status": "A",
        "authorized_official_last_name": "PABELLON",
        "authorized_official_first_name": "LETICIA",
        "authorized_official_title_or_position": "VP OF ADMINISTRATIVE OPERATIONS",
        "authorized_official_telephone_number": "516-321-2447"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "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 Mar 29, 2018; 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.