Provider Demographics
NPI:1114441474
Name:TOUCH OF LIFE PHYSICAL THERAPY P.C.
Entity Type:Organization
Organization Name:TOUCH OF LIFE PHYSICAL THERAPY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JONGIL
Authorized Official - Middle Name:
Authorized Official - Last Name:JO
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:347-200-7412
Mailing Address - Street 1:136 E 57TH ST STE 801
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-2971
Mailing Address - Country:US
Mailing Address - Phone:347-200-7412
Mailing Address - Fax:
Practice Address - Street 1:136 E 57TH ST STE 801
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-2971
Practice Address - Country:US
Practice Address - Phone:347-200-7412
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035146225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty