Provider Demographics
NPI:1073049714
Name:HANWOL PHYSICAL THERAPY P.C.
Entity Type:Organization
Organization Name:HANWOL PHYSICAL THERAPY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PT/DPT
Authorized Official - Prefix:
Authorized Official - First Name:JIHO
Authorized Official - Middle Name:
Authorized Official - Last Name:NOH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-250-0391
Mailing Address - Street 1:3901 MAIN ST
Mailing Address - Street 2:SUITE 309
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-5432
Mailing Address - Country:US
Mailing Address - Phone:917-250-0391
Mailing Address - Fax:
Practice Address - Street 1:3901 MAIN ST
Practice Address - Street 2:SUITE 309
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5432
Practice Address - Country:US
Practice Address - Phone:917-563-1373
Practice Address - Fax:646-786-4826
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-01
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY037556225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty