Provider Demographics
NPI:1942067236
Name:SYSTEM PHYSICAL THERAPY CORP.
Entity Type:Organization
Organization Name:SYSTEM PHYSICAL THERAPY CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JUNE MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:845-309-5508
Mailing Address - Street 1:2380 KUHIO AVE APT 1116
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815-5044
Mailing Address - Country:US
Mailing Address - Phone:845-309-5508
Mailing Address - Fax:
Practice Address - Street 1:4211 WAIALAE AVE STE 303
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-5316
Practice Address - Country:US
Practice Address - Phone:845-309-5508
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty