Individual provider Active NPI

Leslie Elizabeth Avendano, PT, MS

  • Pediatric Physical Therapist
  • Fresh Meadows, NY
National Provider Identifier
1992959050
Registry record updated Nov 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
023900-1 Issued in NY
Practice address
15813 72ND Ave
Fresh Meadows, NY 11365-4100
Phone
(718) 380-7600
Fax
(718) 380-6092
NPI assigned
Nov 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X 023900-1 NY Primary

Addresses

Primary practice location

15813 72ND Ave
Fresh Meadows, NY 11365-4100

Mailing address

22 Parma Rd
Island Park, NY 11558-1516
Phone (718) 679-2169

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
023900NYMDCognitive & Behavioral Psychologist
023900-1NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1226707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226707200000",
    "number": "1992959050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 PARMA RD",
            "city": "ISLAND PARK",
            "state": "NY",
            "postal_code": "115581516",
            "telephone_number": "718-679-2169",
            "fax_number": "516-665-2607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15813 72ND AVE",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113654100",
            "telephone_number": "718-380-7600",
            "fax_number": "718-380-6092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVENDANO",
        "first_name": "LESLIE",
        "middle_name": "ELIZABETH",
        "credential": "PT, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-15",
        "last_updated": "2008-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NY",
            "license": "023900-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresh Meadows, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2008; 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.