Provider Demographics
NPI:1356092837
Name:BODYFIRST PHYSICAL THERAPY P.C.
Entity Type:Organization
Organization Name:BODYFIRST PHYSICAL THERAPY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SUNGJUN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAE
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:347-569-2107
Mailing Address - Street 1:535 BROADHOLLOW RD STE B12
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-3701
Mailing Address - Country:US
Mailing Address - Phone:631-626-9299
Mailing Address - Fax:631-693-3399
Practice Address - Street 1:535 BROADHOLLOW RD STE B12
Practice Address - Street 2:
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-3701
Practice Address - Country:US
Practice Address - Phone:631-626-9299
Practice Address - Fax:631-693-3399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-16
Last Update Date:2022-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty