Provider Demographics
NPI:1508331943
Name:MYUNGYOON NY PHYSICAL THERAPY PC
Entity Type:Organization
Organization Name:MYUNGYOON NY PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MYUNG YOON
Authorized Official - Middle Name:
Authorized Official - Last Name:SEO
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:646-666-0322
Mailing Address - Street 1:14348 41ST AVE APT 5F
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-1870
Mailing Address - Country:US
Mailing Address - Phone:917-563-1560
Mailing Address - Fax:917-908-0355
Practice Address - Street 1:3636 PRINCE ST STE 308
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-4031
Practice Address - Country:US
Practice Address - Phone:917-563-1560
Practice Address - Fax:917-908-0355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-12
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty