1003832692 NPI number — KINGSLEY-HYLKEMA PHYSICAL THERAPY, P.C.

Table of content: MR. ANILKUMAR GOKANI P.T. (NPI 1396973806)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003832692 NPI number — KINGSLEY-HYLKEMA PHYSICAL THERAPY, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KINGSLEY-HYLKEMA PHYSICAL THERAPY, P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
DYNAMIC PHYSICAL THERAPY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003832692
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/02/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3752 ROUTE 9G
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RHINEBECK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12572-1173
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-876-8220
Provider Business Mailing Address Fax Number:
845-876-8221

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3752 ROUTE 9G
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RHINEBECK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12572-1173
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-876-8220
Provider Business Practice Location Address Fax Number:
845-876-8221
Provider Enumeration Date:
07/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HYLKEMA
Authorized Official First Name:
INGRID
Authorized Official Middle Name:
JOHANNA SJOERDJE
Authorized Official Title or Position:
PHYSICAL THERAPIST
Authorized Official Telephone Number:
845-876-8220

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  015726-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: KI0Q0WSI10 . This is a "MEDICARE EMC GROUP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: QL6862 . This is a "MEDICARE THOMAS KINGSLEY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: QL6872 . This is a "MEDICARE INGRID HYLKEMA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1639184542 . This is a "INGRID HYLKEMA NPI#" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1720094881 . This is a "THOMAS KINGSLEY NPI#" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: IH0QL68720 . This is a "MEDICARE I.HYLKEMA EMC" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: TK0QL68620 . This is a "MEDICARE T.KINGSLEY EMC" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: QL686Q0SI1 . This is a "MEDICARE T.KINGSLEY PAPER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: QL687Q0SI1 . This is a "MEDICARE I.HYLKEMA PAPER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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