Active NPI
Mia E Azcue, PT
- Physical Therapist
- Putnam Valley, NY
National Provider Identifier
1992832349
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 11211-1
- Practice address
- 21 Peekskill Hollow Rd Ste 201
Putnam Valley, NY 10579-3254 - Phone
- (845) 528-3133
- NPI assigned
- Feb 27, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 11211-1 | NY | Primary |
Addresses
Primary practice location
21 Peekskill Hollow Rd Ste 201
Putnam Valley, NY 10579-3254
Mailing address
11 Quail RDG
Putnam Valley, NY 10579-3108
Phone (845) 528-8565
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 011211 | NY | MD | Optometrist |
| 11211-1 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288656000000",
"number": "1992832349",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 QUAIL RDG",
"city": "PUTNAM VALLEY",
"state": "NY",
"postal_code": "105793108",
"telephone_number": "845-528-8565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21 PEEKSKILL HOLLOW RD STE 201",
"city": "PUTNAM VALLEY",
"state": "NY",
"postal_code": "105793254",
"telephone_number": "845-528-3133"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AZCUE",
"first_name": "MIA",
"middle_name": "E",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-27",
"last_updated": "2010-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "11211-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Putnam Valley, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.