N/A (NPI# 1134676588) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134676588 |
| Entity Type | Organization |
| Organization Name | N/A |
| Practice Address |
25 Fanning St Staten Island NY 10314-5307 |
| Mailing Address |
657 Collfield Ave Staten Island NY 10314-4258 |
| Practice Telephone | 7186982475 |
| Mailing Telephone | 7186982475 |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2016-09-01 |
| Authorized Official Name | MR. JOHN THOMAS (PHYSICAL THERAPIST) |
| Authorized Official Telephone | 7186190170 |
| Authorized Official Credential | PT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
039429 | NY | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811428980 | N/a | Nurse Practitioner | 6045 Sw 162nd Ave, Miami, FL 33193-5805 | 2017-03-21 |
| 1346783776 | N/a | Exclusive Provider Organization | Av. Tecnologico 183, Nuevo Laredo, TAMAULIPAS 88275 | 2016-12-03 |
| 1871953216 | N/a | Community/Behavioral Health | 1203 Saint Lawrence Ave, Beloit, WI 53511-5067 | 2016-02-27 |
| 1205207511 | N/a | Home Health | 3051 Elyria Ave, Lorain, OH 44055-1449 | 2015-10-13 |
| 1245652247 | N/a | Home Health | 2261 S Sherman Cir, Apt. A204, Miramar, FL 33025-2294 | 2014-01-09 |
| 1871868927 | N/a | Skilled Nursing Facility | 3108 Island Ct, Jeffersonville, IN 47130-8058 | 2012-03-21 |
| 1801163118 | N/a | Registered Nurse | 29078 Providence Rd, Temecula, CA 92591-5597 | 2011-11-30 |
| 1871888388 | N/a | Assisted Living Facility | 2998 W Mcmicken Ave # 1, Cincinnati, OH 45225-2362 | 2011-06-13 |
| 1861782898 | N/a | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1318 Pennsylvania Ave, Saint Louis, MO 63133-1036 | 2011-04-11 |
| 1194055749 | N/a | Community/Behavioral Health | 4051 Lone Tree Way Ste C, Antioch, CA 94531-6204 | 2010-01-04 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | N/A | 3117 Apple Rd Ne, Washington, DC 20018-1605 |
| Colorado Business Entities | n/a | 4165 Plum Creek Mdws Rd., Sedalia, CO 80135 |
| Washington State Corporations | N/A CEDAR HEIGHTS-52, A WASHINGTON LIMITED PARTNERSHIP | 999 3rd Ave #1900, Seattle, WA 98104 |
| Oregon Corporations, Companies and Business Names | N/A COLONNADE-83, LIMITED PARTNERSHIP | 920 Garden St Ste A, Santa Barbara, CA 93101 |
| Colorado Business Entities | N/A Courtney Downs-89, L.P. | 920 Garden Street, Suite A, Santa Barbara, CA 93101 |
| Washington State Corporations | N/A EAGLE RANCH-67 LIMITED PARTNERSHIP | 101 Capitol Way N, Olympia, WA 98501 |
| System for Award Management (SAM) Entities | N/A INDIVIDUAL | 900 N. Lake Shore Drive Apt 402, Chicago, IL 60611-1596 |
| Colorado Business Entities | N/A Lambertson Farms-86, L.P. | 920 Garden St Ste A, Santa Barbara, CA 93101-7465 |
| Washington State Corporations | N/A MARINERS' GLEN-68, LP | 920 Garden St, Santa Barbara, CA 93101 |
| Washington State Corporations | N/A MILL PLAIN-84, L.P. | 920 Garden St, Santa Barbara, CA 93101 |
| Street Address |
25 FANNING ST |
| City | STATEN ISLAND |
| State | NY |
| Zip Code | 10314-5307 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417952417 | Clove Lakes Health Care and Rehabilitation Center, Inc. | Skilled Nursing Facility | 25 Fanning St, Staten Island, NY 10314-5307 | 2005-06-16 |
| 1285038141 | Wuraola Ismaila | Registered Nurse | 25 Fanning St, Staten Island, NY 10314-5307 | 2014-10-21 |
| 1306086707 | Suma Mariam Kuriakose | Physical Therapist | 25 Fanning St, Staten Island, NY 10314-5307 | 2009-02-24 |
| 1750506853 | John Thomas | Physical Therapy Assistant | 25 Fanning St, Staten Island, NY 10314-5307 | 2007-04-16 |
| 1659314193 | Clove Lakes Rehabilitation and Outpatient Services | Speech-Language Pathologist | 25 Fanning St, Staten Island, NY 10314-5307 | 2006-06-13 |
| 1669453502 | Island Rehabilitative Services Corp | Clinic/Center | 25 Fanning St, Staten Island, NY 10314-5307 | 2005-11-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568076255 | Edward Leccese | Massage Therapist | 77 Renee Place, Staten Island, NY 10314 | 2020-09-01 |
| 1871154633 | Matthew Richard Puliatti | Counselor | 1688 Victory Boulevard, Staten Island, NY 10314 | 2019-06-24 |
| 1750845137 | Miriam Gordon Pediatric Np PC | Nurse Practitioner | 7 Ismay Street, Staten Island, NY 10314 | 2019-01-30 |
| 1003391186 | 2791 Richmond LLC | Dentist | 2791 Richmond Avenue, Suite 2, Staten Island, NY 10314 | 2018-09-25 |
| 1477046522 | Miriam A Madry | Optometrist | 569 Woolley Ave, Staten Island, NY 10314 | 2018-06-13 |
| 1174025894 | Staten Island Dentistry P.C. | Clinic/Center | 979 Willowbrook Rd., Staten Island, NY 10314 | 2018-03-08 |
| 1205335023 | Ashley Larsen | Early Intervention Provider Agency | 229 Wellington Ct, Staten Island, NY 10314 | 2018-02-07 |
| 1306369699 | Victoria Ali | Behavior Technician | 228 Melvin Avenue, Staten Island, NY 10314 | 2017-07-19 |
| 1700307360 | Lydia Mora | Specialist | 2025 Richmond Avenue Suite 200, Staten Island, NY 10314 | 2017-07-03 |
| 1366971707 | Lisa Pietracatella | Massage Therapist | 92 Margaretta Court, Staten Island, NY 10314 | 2017-06-08 |
| Find all providers in zip 10314 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740892421 | Total Cure Pt PC | Clinic/Center | 620 Bloomingdale Rd, Staten Island, NY 10309-2028 | 2020-08-23 |
| 1215550363 | Target Physical Therapy PC | Clinic/Center | 483 Ingram Ave, Staten Island, NY 10314-4414 | 2020-05-24 |
| 1205337300 | Ryan Dinneny | Clinic/Center | 19 Emmet Ave, Staten Island, NY 10306-2719 | 2018-02-23 |
| 1730699448 | Therapy Masters, LLC | Clinic/Center | 1434 Forest Hill Rd, Staten Island, NY 10314-6318 | 2017-10-08 |
| 1205358025 | Big City Physical Therapy, Pllc | Clinic/Center | 3202 Morley Ave, Staten Island, NY 10306-1906 | 2017-07-13 |
| 1821474263 | M.e.p.t. Physical Therapy, P.C. | Clinic/Center | 322 Lathrop Ave, Staten Island, NY 10302-2532 | 2015-08-07 |
| 1689051260 | Precious Movements Physical Therapy, P.C. | Clinic/Center | 1592 Richmond Ave, Staten Island, NY 10314-1529 | 2015-05-02 |
| 1710011465 | Lugo Comprehensive Pt Services | Clinic/Center | 515 Neckar Ave, Staten Island, NY 10304-4511 | 2007-03-15 |
| 1528179306 | Richard P Orsini | Clinic/Center | 104 Amaron Ln, Staten Island, NY 10307-1963 | 2006-08-31 |
| 1255442034 | Larry Codner | Clinic/Center | 116 Hampton Grn, Staten Island, NY 10312-1739 | 2006-08-31 |
| Find all providers in STATEN ISLAND | ||||
| City | STATEN ISLAND |
| Zip Code | 10314 |
Please comment or provide details below to improve the information on N/A.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.