DYNAMIC PHYSICAL THERAPY OF QUEENS PLLC (NPI# 1609288331) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609288331 |
| Entity Type | Organization |
| Organization Name | DYNAMIC PHYSICAL THERAPY OF QUEENS PLLC |
| Other Organization Name | DYNAMIC PT OF QUEENS |
| Practice Address |
5718 Woodside Ave 2flr Suite#103 Woodside NY 11377-3415 |
| Mailing Address |
6248 80th St Fl 2 Middle Village NY 11379-1323 |
| Practice Telephone | 7182050030 |
| Practice Fax Number | 6463048252 |
| Mailing Telephone | 7184292888 |
| Mailing Fax Number | 6463048252 |
| Enumeration Date | 2014-05-29 |
| Last Update Date | 2014-05-29 |
| Authorized Official Name | MR. CHRISTOPHER ANTHONY BAUTISTA (PRACTICE ADMNISTRATOR) |
| Authorized Official Telephone | 9143099564 |
| Authorized Official Credential | MBA |
| 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 |
| Other Name | Type Code |
|---|---|
| Dynamic PT of Queens | Doing Business As Name - Organization |
| Street Address |
5718 WOODSIDE AVE 2FLR SUITE#103 |
| City | WOODSIDE |
| State | NY |
| Zip Code | 11377-3415 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144332511 | Brian T Mcneary | Specialist | 5718 Woodside Ave, 203, Woodside, NY 11377-3444 | 2006-08-31 |
| 1386925873 | Resilient Care Physical Therapy LLC | Health Maintenance Organization | 5718 Woodside Ave, Suite B102, Woodside, NY 11377-3415 | 2011-08-29 |
| 1760615603 | Hemali M Ajmera | Dentist | 5718 Woodside Ave, Ste 203, Woodside, NY 11377-3444 | 2009-08-26 |
| 1306037247 | Erie T Agustin Md PC | Clinic/Center | 5718 Woodside Ave, Woodside, NY 11377-3444 | 2007-08-06 |
| 1700925880 | Amado E Conanan | Physical Therapist | 5718 Woodside Ave, 2nd Floor, Woodside, NY 11377-3444 | 2007-02-06 |
| 1639216617 | Stacy Lee Shanahan | Physician Assistant | 5718 Woodside Ave, Woodside, NY 11377-3444 | 2007-01-31 |
| 1467520312 | Joseph James Upton | Chiropractor | 5718 Woodside Ave, Suite B102, Woodside, NY 11377-3444 | 2006-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295353738 | Qw Pharmacy Inc | Pharmacy | 54-03 Roosevelt Ave., Woodside, NY 11377 | 2020-07-10 |
| 1689214348 | Reilly Abbott | Social Worker | 42-77 65th Pl, Woodside, NY 11377 | 2020-01-10 |
| 1134767833 | Queens Boulevard Chiropractic P.C. | Chiropractor | 51-27 Queens Blvd, 2nd Fl 2c, Woodside, NY 11377 | 2019-12-13 |
| 1497313399 | Aftab Ahmed | Pharmacist | 5801 Woodside Ave # 3, Woodside, NY 11377 | 2019-06-05 |
| 1780240606 | Simple Therapy Pt PC | Clinic/Center | 49-03 69th Street, Unit B, Woodside, NY 11377 | 2019-05-15 |
| 1386115046 | Andrea Charidemou | Social Worker | 42-77 62nd Pl, Woodside, NY 11377 | 2018-12-06 |
| 1952870198 | American United Medicine PC | Allergy & Immunology | 5314 Roosevelt Ave., Ste 302, Rm 5, Woodside, NY 11377 | 2018-11-16 |
| 1396226999 | Michelle Xian | Social Worker | 42-77 65th Pl., Woodside, NY 11377 | 2018-08-22 |
| 1598253759 | Noel Melon Nuevas | Physical Therapy Assistant | 63 08 39th Ave, Woodside, NY 11377 | 2018-04-24 |
| 1992206585 | Sixtieth Family Dental,pllc | Clinic/Center | 6019 Roosevelt Ave Ste 225, Woodside, NY 11377 | 2018-02-28 |
| Find all providers in zip 11377 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780240606 | Simple Therapy Pt PC | Clinic/Center | 49-03 69th Street, Unit B, Woodside, NY 11377 | 2019-05-15 |
| 1336417278 | One To One Physical Therapy,pc | Clinic/Center | 63-15/17 39th Avenue, Woodside, NY 11377 | 2011-12-07 |
| 1073895884 | Active In-home Therapy | Clinic/Center | 1111 Canada Rd, Woodside, CA 94062-3508 | 2011-09-16 |
| 1760659239 | Malcan Physical Therapy, P.C. | Clinic/Center | 5011 Queens Blvd Bsmt, Woodside, NY 11377-4469 | 2008-05-13 |
| 1528140704 | One To One Physical Therapy PC | Clinic/Center | 6315 39th Ave, Woodside, NY 11377 | 2006-10-19 |
| 1013974476 | Orthopedic Physical Therapy PC | Clinic/Center | 4128 71st St, Ste Ca, Woodside, NY 11377 | 2006-04-28 |
| 1063051456 | Well Street Occupational Therapy, Pllc | Clinic/Center | 3960 54th St Apt 7p, Woodside, NY 11377-4217 | 2020-01-02 |
| 1689136772 | Lorena Vargas | Clinic/Center | 4277 65th Pl, Woodside, NY 11377-5054 | 2019-04-05 |
| 1881130250 | Rcg Pt PC | Clinic/Center | 7206 44th Ave, Apt. 2, Woodside, NY 11377-3951 | 2017-01-10 |
| 1649629585 | Marycare Physical Therapy P.C. | Clinic/Center | 4757 43rd St, Woodside, NY 11377-6243 | 2016-06-10 |
| Find all providers in WOODSIDE | ||||
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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.