Provider Demographics
NPI:1922387554
Name:DR HAN PHYSICAL THERAPY & ACUPUNCTURE PC
Entity Type:Organization
Organization Name:DR HAN PHYSICAL THERAPY & ACUPUNCTURE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PT/LAC
Authorized Official - Prefix:
Authorized Official - First Name:LU
Authorized Official - Middle Name:
Authorized Official - Last Name:HAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-908-8270
Mailing Address - Street 1:257 68TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-5208
Mailing Address - Country:US
Mailing Address - Phone:718-908-8270
Mailing Address - Fax:
Practice Address - Street 1:517 BAY RIDGE PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-3309
Practice Address - Country:US
Practice Address - Phone:718-908-8270
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-14
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002120171100000X
NY031568-1261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty