Provider Demographics
NPI:1851631063
Name:JOS ONE PHYSICAL THERAPY PC
Entity Type:Organization
Organization Name:JOS ONE PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MOON HEE
Authorized Official - Middle Name:
Authorized Official - Last Name:JO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-703-3575
Mailing Address - Street 1:11474 DALIAN CT
Mailing Address - Street 2:FL 1
Mailing Address - City:COLLEGE POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11356-1575
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14232 38TH AVE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5526
Practice Address - Country:US
Practice Address - Phone:718-888-0072
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-25
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty