101 Avenue Physical Therapy PC
Physical Therapist in Great Neck, NY. Organization (NPI-2).
NPI number1710404173
StatusActive
Last updated in NPPESAug 26, 2017
Details
- NPI
- 1710404173
- Entity type
- Organization (NPI-2)
- Legal business name
- 101 Avenue Physical Therapy PC
- Organization subpart
- No
- Enumeration date
- Aug 26, 2017
- Last updated
- Aug 26, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | 36145 | NY | Yes |
Practice location
277 Northern Blvd Ste 301Great Neck, NY 11021-4703
Phone 516-472-7861
Mailing address
277 Northern Blvd Ste 301Great Neck, NY 11021-4703
Authorized official
Changhun Lee
President
5164728761
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