Provider Demographics
NPI:1851970230
Name:FLUSHING PHYSICAL THERAPY & CHIROPRACTIC, PLLC
Entity Type:Organization
Organization Name:FLUSHING PHYSICAL THERAPY & CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:SANGWOO
Authorized Official - Middle Name:
Authorized Official - Last Name:MAH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:917-626-3037
Mailing Address - Street 1:15001 NORTHERN BLVD FL 1
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-3896
Mailing Address - Country:US
Mailing Address - Phone:718-746-4919
Mailing Address - Fax:
Practice Address - Street 1:15001 NORTHERN BLVD FL 1
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-3896
Practice Address - Country:US
Practice Address - Phone:718-746-4919
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-05
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty