Look up the most recent NPI and PECOS records

Maximous Pt Pllc

(<Unavail>)

Physical Therapist

Respiratory, Developmental, Rehabilitative and Restorative Service Providers

4870 Hylan Blvd, Staten Island, NY 10312-6322

PECOS Enrollment

Based on the most recent information from CMS, provider Maximous Pt Pllc does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 34 days ago.

Profile Details

Provider ID
1750071049
Provider Type
Organization
Full Name
Maximous Pt Pllc
Other Name
<Unavail>

Subpart
No
Enumeration Date
5/10/2023
Last Updated
9/10/2024

Contact Information

Practice Location

4870 Hylan Blvd, Staten Island, NY 10312-6322

(347) 559-4085

Unlisted Fax

Mailing Location

47 Brook Ave, Staten Island, NY 10306-4434

Unlisted Phone

Unlisted Fax

Authorized Official

Maximous, Bishoy (Physical Therapist)

(347) 559-4085

Provider Taxonomies

Code	Description	License
Code 225100000X Primary	Description Physical Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers	License Unlisted Issuer

Maximous Pt Pllc

(<Unavail>)

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Authorized Official

Provider Taxonomies

Code

Description

License

Code

Description

License

Fedosseev, Vladimir

Balboa Pt

Labbate, Daniela

Murray, Mary Ann

Ranganathan, Swethambari

Trezza, Denise

Agnieszka Antecka Pt Pc

Pacchiano, Mark Anthony

Chigurupati, Sirisha

Nemtsova, Yelena