MEDICARE: MR. JIMMY COLAPO NIDUAZA PTA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant	013604-01	NY

General Provider Information

NPI Number	:	1538867189
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JIMMY COLAPO NIDUAZA PTA

Provider Business Mailing Address
First Line	:	3804 BAILEY AVE APT A3
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10463-2541
Country	:	US
Telephone Number	:	347-917-6247
Fax Number	:

Provider Business Practice Location Address
First Line	:	3804 BAILEY AVE APT A3
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10463-2541
Country	:	US
Telephone Number	:	347-917-6247
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/22/2023
Last Update Date	:	06/06/2026

Similar Medicare Providers

1831458702 — CROTONA PHARMACY CORP
Practice Location Address:

1384 BOSTON RD
BRONX, NY
10456-2541

Practice Phone: 917-688-1102
Practice Fax: 917-688-1104

1972968394 — CHILDREN'S SPEICALIZED HOSPITAL
Practice Location Address:

5400 FIELDSTON RD , 62F
BRONX, NY
10471-2541

Practice Phone: 917-538-9275
Practice Fax:

1467900860 — MEDS4DAYS PHARMACY INC
Practice Location Address:

1384 BOSTON RD
BRONX, NY
10456-2541

Practice Phone: 917-688-1102
Practice Fax: 917-688-1104

1902549405 — SHAUNTAY JACKSON LMFT
Practice Location Address:

2541 OLINVILLE AVE APT 4B
BRONX, NY
10467-7491

Practice Phone: 347-318-7140
Practice Fax:

1053178921 — ANDRES GERARDO SOTO BURGOS
Practice Location Address:

2541 FENTON AVE
BRONX, NY
10469-5602

Practice Phone: 347-591-8809
Practice Fax:

1962180851 — JANHVI REVANAND ANDHALE PTA,MS
Practice Location Address:

2735 HENRY HUDSON PKWY STE 103
BRONX, NY
10463-4701

Practice Phone: 718-884-0444
Practice Fax: 718-549-0415

Directions to “ MR. JIMMY COLAPO NIDUAZA PTA” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.