Individual provider Active NPI

Maureen Mallari Perido, P.T.

  • Physical Therapist
  • Glen Oaks, NY
National Provider Identifier
1982911152
Registry record updated Sep 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
62-022253 Issued in NY
Practice address
7148 260TH St
1St FL.
Glen Oaks, NY 11004-1151
Phone
(917) 330-0785
NPI assigned
Sep 8, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 62-022253 NY Primary

Addresses

Primary practice location

7148 260TH St
1St FL.
Glen Oaks, NY 11004-1151

Mailing address

7148 260TH St
1St FL.
Glen Oaks, NY 11004-1151
Phone (917) 330-0785

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
62-022253NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1283904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283904000000",
    "number": "1982911152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7148 260TH ST",
            "address_2": "1ST FL.",
            "city": "GLEN OAKS",
            "state": "NY",
            "postal_code": "110041151",
            "telephone_number": "917-330-0785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7148 260TH ST",
            "address_2": "1ST FL.",
            "city": "GLEN OAKS",
            "state": "NY",
            "postal_code": "110041151",
            "telephone_number": "917-330-0785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERIDO",
        "first_name": "MAUREEN",
        "middle_name": "MALLARI",
        "name_prefix": "Ms.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-08",
        "last_updated": "2010-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "62-022253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Oaks, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2010; 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.