Provider Demographics
NPI:1982015046
Name:WAY2HEALTH PHYSICAL THERAPY
Entity Type:Organization
Organization Name:WAY2HEALTH PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:YI LILY
Authorized Official - Middle Name:
Authorized Official - Last Name:ZHANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-803-3883
Mailing Address - Street 1:4115 75TH ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-1811
Mailing Address - Country:US
Mailing Address - Phone:718-803-3883
Mailing Address - Fax:718-803-3884
Practice Address - Street 1:4115 75TH ST
Practice Address - Street 2:SUITE 2
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-1811
Practice Address - Country:US
Practice Address - Phone:718-803-3883
Practice Address - Fax:718-803-3884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-12
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002081-1171100000X
NY015633-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty