Provider Demographics
NPI:1578865960
Name:SILOA PT,P.C.
Entity Type:Organization
Organization Name:SILOA PT,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPY
Authorized Official - Prefix:
Authorized Official - First Name:EUNSEONG
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-797-8512
Mailing Address - Street 1:13618 35TH AVE # 1B
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-2943
Mailing Address - Country:US
Mailing Address - Phone:917-797-8512
Mailing Address - Fax:718-463-8880
Practice Address - Street 1:13618 35TH AVE # 1B
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-2943
Practice Address - Country:US
Practice Address - Phone:917-797-8512
Practice Address - Fax:718-463-8880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-17
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020751261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy