Provider Demographics
NPI:1609630383
Name:FULTON STREET PHYSICAL THERAPY PLLC
Entity Type:Organization
Organization Name:FULTON STREET PHYSICAL THERAPY PLLC
Other - Org Name:KWEEWA PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HSING-I
Authorized Official - Middle Name:
Authorized Official - Last Name:HSIEH
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:857-259-3392
Mailing Address - Street 1:171 LEXINGTON AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-4930
Mailing Address - Country:US
Mailing Address - Phone:917-319-4162
Mailing Address - Fax:
Practice Address - Street 1:139 FULTON ST RM 719
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-2533
Practice Address - Country:US
Practice Address - Phone:857-259-3392
Practice Address - Fax:929-273-0597
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-12
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy