Provider Demographics
NPI:1629395009
Name:CHI, KI CHI (PT, DPT, OCS)
Entity Type:Individual
Prefix:
First Name:KI
Middle Name:CHI
Last Name:CHI
Suffix:
Gender:M
Credentials:PT, DPT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5008 7TH AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-2167
Mailing Address - Country:US
Mailing Address - Phone:718-210-1101
Mailing Address - Fax:718-210-5238
Practice Address - Street 1:5008 7TH AVE STE 1
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-2167
Practice Address - Country:US
Practice Address - Phone:718-210-1101
Practice Address - Fax:718-210-5238
Is Sole Proprietor?:No
Enumeration Date:2010-04-26
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0276042251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic