Fresh Pond Physical Therapy Astoria, P.C.
NPI 1477819084ActiveOrganization· Physical Therapist· Astoria, NY
Physical Therapist in Astoria, New York, registered in NPPES in April 2012. The authorized official on file is Liza Tan, DPT, PT, Ceo. Enrolled in Medicare as part b supplier - physical/occupational therapy group in private practice.
Overview
| NPI | 1477819084 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Apr 9, 2012 |
| Last updated in NPPES | May 20, 2016 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | 015401-1 | NY |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Physical/Occupational Therapy Group in Private Practice (NY) |
|---|
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