WYCKOFF PHYSICAL THERAPY PC. (NPI# 1629442793) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629442793 |
| Entity Type | Organization |
| Organization Name | WYCKOFF PHYSICAL THERAPY PC. |
| Practice Address |
6805 Fresh Pond Rd Ridgewood NY 11385-5200 |
| Mailing Address |
201 Saint Nicholas Ave Brooklyn NY 11237-4840 |
| Practice Telephone | 7184562543 |
| Practice Fax Number | 7185596784 |
| Mailing Telephone | 7188219511 |
| Mailing Fax Number | 7185596784 |
| Enumeration Date | 2015-11-30 |
| Last Update Date | 2016-05-20 |
| Authorized Official Name | JENNY TAN (BILLING & COLLECTION DEPT. HEAD) |
| Authorized Official Telephone | 7184562543 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities |
| Street Address |
6805 FRESH POND RD |
| City | RIDGEWOOD |
| State | NY |
| Zip Code | 11385-5200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508844036 | Fresh Pond Physical Therapy, P.c | Physical Therapist | 6805 Fresh Pond Rd, Ridgewood, NY 11385-5200 | 2006-01-04 |
| 1568009116 | Shevvie Sialana | Physical Therapist | 6805 Fresh Pond Rd, Ridgewood, NY 11385-5200 | 2019-12-03 |
| 1538724877 | Raylyn Joven | Physical Therapist | 6805 Fresh Pond Rd, Ridgewood, NY 11385-5200 | 2019-05-02 |
| 1710462999 | Jairus Gaberiel Maglasang Flores | Physical Therapist | 6805 Fresh Pond Rd, Ridgewood, NY 11385-5200 | 2018-10-03 |
| 1922587443 | Cresilda Tejano Abella | Physical Therapist | 6805 Fresh Pond Rd, Ridgewood, NY 11385-5200 | 2018-08-07 |
| 1518444165 | Swati Ramchandra Kommu | Physical Therapist | 6805 Fresh Pond Rd, Ridgewood, NY 11385-5200 | 2018-07-26 |
| 1205326774 | Bryan Rivera | Physical Therapist | 6805 Fresh Pond Rd, Ridgewood, NY 11385-5200 | 2018-05-10 |
| 1174068720 | Mohamed Khallaf | Physical Therapist | 6805 Fresh Pond Rd, Ridgewood, NY 11385-5200 | 2017-01-05 |
| 1669915534 | Pragna Sadula | Physical Therapist | 6805 Fresh Pond Rd, Ridgewood, NY 11385-5200 | 2016-11-28 |
| 1245602853 | Dexter Bongato | Clinic/Center | 6805 Fresh Pond Rd, Ridgewood, NY 11385-5200 | 2015-10-22 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326650425 | Nicole Jablonska | Speech-Language Pathologist | 60-24 Grove Street, Ridgewood, NY 11385 | 2020-08-19 |
| 1295393296 | Ila Debra Christmas | Clinic/Center | 67-29 Myrtle Avenue, Glendale, NY 11385 | 2019-06-04 |
| 1164929584 | Carmen E. Vidal | Case Manager/Care Coordinator | 61-06 Metropolitan Ave., Ridgewood, NY 11385 | 2018-04-11 |
| 1467955385 | Avchemists LLC | Pharmacy | 68-28 Myrtle Ave, Glendale, NY 11385 | 2018-03-16 |
| 1235639667 | Yu-jen Hwang | Physical Therapist | 55-05 Myrtle Avenue, 2nd Floor, Ridgewood, NY 11385 | 2018-02-12 |
| 1477069185 | Selena Delgado | Behavior Technician | 64-07 Cooper Avenue, Glendale, NY 11385 | 2017-12-18 |
| 1851806913 | Myrtle Medical Equipment Inc | Durable Medical Equipment & Medical Supplies | 7933 Myrtle Ave, Flushing, NY 11385 | 2017-12-11 |
| 1104345727 | Suzanne Eng | Counselor | 1080 Wykoff Ave., Suite D4, Ridgewood, NY 11385 | 2017-09-14 |
| 1588183339 | Geri P Services Inc. | Early Intervention Provider Agency | 5938 Gates Ave, Ridgewood, NY 11385 | 2017-09-13 |
| 1922523935 | Kristen Michele Spang | Speech-Language Pathologist | 79-56 77th Road, Glendale, NY 11385 | 2017-08-10 |
| Find all providers in zip 11385 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639725229 | One Hand 1 Physical Therapy PC | Clinic/Center | 6685 Forest Ave, Ridgewood, NY 11385-3839 | 2019-08-10 |
| 1972144434 | Neck and Back Pt LLC | Clinic/Center | 228 E Glen Ave, Ridgewood, NJ 07450-1728 | 2019-10-04 |
| 1245602853 | Dexter Bongato | Clinic/Center | 6805 Fresh Pond Rd, Ridgewood, NY 11385-5200 | 2015-10-22 |
| 1649642315 | Ahmed Abdelaty | Clinic/Center | 6805 Fresh Pond Rd, Ridgewood, NY 11385-5200 | 2015-10-21 |
| 1942672696 | Oliver Cayetano | Clinic/Center | 6805 Fresh Pond Rd, Ridgewood, NY 11385-5200 | 2015-10-21 |
| 1598137267 | Alexander Guillera | Clinic/Center | 6805 Fresh Pond Rd, Ridgewood, NY 11385-5200 | 2015-10-21 |
| 1962885491 | Fresh Pond Physical Therapy, P.c | Clinic/Center | 6805 Fresh Pond Rd, Ridgewood, NY 11385-5200 | 2015-07-01 |
| 1356776991 | Jessica Leigh Grimm | Clinic/Center | 104 Chestnut St, Ridgewood, NJ 07450-2502 | 2013-09-12 |
| 1548340052 | Ridgewood Physical Therapy and Rehabilitation Center Inc. | Clinic/Center | 104 Chestnut St, Ridgewood, NJ 07450-2502 | 2006-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225639842 | Lion Physical Therapy Pllc | Clinic/Center | 2420 Jackson Ave Ste 205, Long Island City, NY 11101-4332 | 2020-11-02 |
| 1144820762 | Phoenix Physical Therapy Pllc | Clinic/Center | 337 Blaisdell Rd, Orangeburg, NY 10962-2508 | 2020-11-01 |
| 1174122808 | The Body Workshop Physical Therapy Pllc | Clinic/Center | 70 Balsam Way, Clifton Park, NY 12065-6787 | 2020-10-23 |
| 1013516012 | Laura Alexandra Kelly | Clinic/Center | 599 Knollwood Rd, White Plains, NY 10603-1918 | 2020-10-21 |
| 1982202404 | Mobility Health Physical Therapy | Clinic/Center | 10545 Avenue M, Brooklyn, NY 11236-4603 | 2020-10-16 |
| 1053919589 | Hun K Physical Therapy P.C. | Clinic/Center | 4015 81st St Apt A65, Elmhurst, NY 11373-1343 | 2020-10-16 |
| 1730786369 | Palisades Lymphedema & Oncology Physiotherapy, Rllp | Clinic/Center | 7 New Lake Rd, Valley Cottage, NY 10989-1868 | 2020-10-06 |
| 1831796713 | Quality Movement Restoration, LLC | Clinic/Center | 12027 165th St, Jamaica, NY 11434-2526 | 2020-10-05 |
| 1134726359 | John Lathrop Physical Therapy Pllc | Clinic/Center | 3152 35th St Apt 1r, Astoria, NY 11106-1546 | 2020-10-01 |
| 1720695430 | John Bianchini Pt PC | Clinic/Center | 11 N Nancy Pl, Massapequa, NY 11758-1912 | 2020-09-26 |
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| 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.