Provider Demographics
NPI:1396833653
Name:EXCELLENT CHOICE PHYSICAL THERAPY, P.C.
Entity Type:Organization
Organization Name:EXCELLENT CHOICE PHYSICAL THERAPY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LINO
Authorized Official - Middle Name:ONG
Authorized Official - Last Name:CHUANG
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:631-396-1595
Mailing Address - Street 1:4701 QUEENS BLVD
Mailing Address - Street 2:SUITE 402
Mailing Address - City:SUNNYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11104-1600
Mailing Address - Country:US
Mailing Address - Phone:718-729-5947
Mailing Address - Fax:718-729-9168
Practice Address - Street 1:4701 QUEENS BLVD
Practice Address - Street 2:SUITE 402
Practice Address - City:SUNNYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11104-1600
Practice Address - Country:US
Practice Address - Phone:718-729-5947
Practice Address - Fax:718-729-9168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYCK6669OtherRAILROAD MEDICARE
NY02292735Medicaid
NYCK6670OtherRAILROAD MEDICARE
NY05069Medicare PIN
NYCK6669OtherRAILROAD MEDICARE