Provider Demographics
NPI:1609888932
Name:DR FU REHABILITATION MEDICAL PC
Entity Type:Organization
Organization Name:DR FU REHABILITATION MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHENZHONG
Authorized Official - Middle Name:
Authorized Official - Last Name:FU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:347-732-4297
Mailing Address - Street 1:13710 FRANKLIN AVE
Mailing Address - Street 2:SUITE L2
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-3835
Mailing Address - Country:US
Mailing Address - Phone:347-732-4297
Mailing Address - Fax:347-732-4299
Practice Address - Street 1:13710 FRANKLIN AVE
Practice Address - Street 2:SUITE L2
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3835
Practice Address - Country:US
Practice Address - Phone:347-732-4297
Practice Address - Fax:347-732-4299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2014-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY230470208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYDR0WNW1310Medicare PIN
NYI24921Medicare UPIN