Provider Demographics
NPI:1659157709
Name:EMERALD PHYSICAL THERAPY & ACUPUNCTURE PC
Entity Type:Organization
Organization Name:EMERALD PHYSICAL THERAPY & ACUPUNCTURE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DPT & LAC/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YU SHIN
Authorized Official - Middle Name:
Authorized Official - Last Name:OH
Authorized Official - Suffix:
Authorized Official - Credentials:DPT & LAC
Authorized Official - Phone:631-923-0334
Mailing Address - Street 1:2227 76TH ST APT B2
Mailing Address - Street 2:
Mailing Address - City:EAST ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11370-1264
Mailing Address - Country:US
Mailing Address - Phone:631-923-0334
Mailing Address - Fax:631-923-0335
Practice Address - Street 1:315 WALT WHITMAN RD STE 214
Practice Address - Street 2:
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746-4112
Practice Address - Country:US
Practice Address - Phone:631-923-0334
Practice Address - Fax:631-923-0335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-05
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty