Provider Demographics
NPI:1043460058
Name:CAREONE PHYSICAL THERAPY, P.C.
Entity Type:Organization
Organization Name:CAREONE PHYSICAL THERAPY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YOUNG
Authorized Official - Middle Name:MAN
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:718-757-8292
Mailing Address - Street 1:7 BROAD AVE
Mailing Address - Street 2:#309
Mailing Address - City:PALISADES PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07650-1403
Mailing Address - Country:US
Mailing Address - Phone:718-757-8292
Mailing Address - Fax:
Practice Address - Street 1:7 BROAD AVE
Practice Address - Street 2:#309
Practice Address - City:PALISADES PARK
Practice Address - State:NJ
Practice Address - Zip Code:07650-1403
Practice Address - Country:US
Practice Address - Phone:718-757-8292
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-25
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01178300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty