Provider Demographics
NPI:1003461179
Name:CAREON PHYSICAL THERAPY PC
Entity Type:Organization
Organization Name:CAREON PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:NAMYOUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:BAEK
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:293-007-1099
Mailing Address - Street 1:16707 29TH AVE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11358-1501
Mailing Address - Country:US
Mailing Address - Phone:929-330-7109
Mailing Address - Fax:347-506-0127
Practice Address - Street 1:75 E BROADWAY BSMT B7
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-6007
Practice Address - Country:US
Practice Address - Phone:212-796-2880
Practice Address - Fax:212-796-2881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-06
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty