Provider Demographics
NPI:1679160493
Name:MOTIONFIT PHYSICAL THERAPY P.C.
Entity Type:Organization
Organization Name:MOTIONFIT PHYSICAL THERAPY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WONHYO
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:347-608-2428
Mailing Address - Street 1:2121 BROADWAY STE 401A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-1786
Mailing Address - Country:US
Mailing Address - Phone:347-608-2428
Mailing Address - Fax:332-999-9240
Practice Address - Street 1:2121 BROADWAY STE 401A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-1786
Practice Address - Country:US
Practice Address - Phone:347-608-2428
Practice Address - Fax:332-999-9240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-28
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY06510030Medicaid