Provider Demographics
NPI:1598973901
Name:PERSONAL TOUCH PHYSICAL MEDICINE & REHABILITATION LLC
Entity Type:Organization
Organization Name:PERSONAL TOUCH PHYSICAL MEDICINE & REHABILITATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KYU WOONG
Authorized Official - Middle Name:
Authorized Official - Last Name:CHO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-783-1577
Mailing Address - Street 1:250 PETTIT AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-3657
Mailing Address - Country:US
Mailing Address - Phone:516-783-1577
Mailing Address - Fax:
Practice Address - Street 1:250 PETTIT AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710-3657
Practice Address - Country:US
Practice Address - Phone:516-783-1577
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY121009208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC08563Medicare UPIN