Provider Demographics
NPI: | 1467002725 |
---|---|
Name: | CENTER POINT PHYSICAL THERAPY, P.C. |
Entity Type: | Organization |
Organization Name: | CENTER POINT PHYSICAL THERAPY, P.C. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PHYSICAL THERAPIST |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | KYUNG WON |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | PARK |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | DPT |
Authorized Official - Phone: | 718-414-5207 |
Mailing Address - Street 1: | 516 W 47TH ST APT N5G |
Mailing Address - Street 2: | |
Mailing Address - City: | NEW YORK |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 10036-2977 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 718-414-5207 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 516 W 47TH ST APT N5G |
Practice Address - Street 2: | |
Practice Address - City: | NEW YORK |
Practice Address - State: | NY |
Practice Address - Zip Code: | 10036-2977 |
Practice Address - Country: | US |
Practice Address - Phone: | 718-414-5207 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2019-09-18 |
Last Update Date: | 2019-09-27 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Single Specialty |